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Thursday, September 19, 2019

Teaneck resident Aviva Breda, 37, told each of her three young children, in distinct ways, and at different times, that she was donating a kidney. For all of them, however, she started with, “Our family is going to do this really great chesed.”

Six-year-old daughter Ruby, the youngest, was told the night before, because her mother didn’t want her to spend too much time worrying. By the next morning, the news had been processed ever so slightly. “Ruby told all of her friends at the bus stop: ‘My mommy’s going to do a very big mitzvah today,” Breda told The Jewish Link.

Ruby was right. After approximately two years of consideration, Breda, through Renewal, a Brooklyn-based organization dedicated to facilitating altruistic kidney donations, donated her kidney on May 21 to a very ill man in his 60s with two children, whom she had never met. She saved his life.

Breda’s two older children, sons Caleb, 15, and Charlie, 11, processed the information about her donating a kidney calmly and asked questions about the details of the process and who would be looking after them when she was hospitalized. They also asked that Breda’s husband, their father, Ben, text them from the hospital once the surgery was over. Ben, 38, stayed with his wife throughout the surgery and through all of the post-surgery hospital stay.

Breda gave a lot of thought to how she should speak to her children about kidney donation. Some inspiration came from Teaneck Chabad’s Rabbi Ephraim Simon, a two-time organ donor who donated his kidney over a decade ago, and then a lobe of his liver this past year. He is one of only four people in the United States to have ever donated both a kidney and a liver lobe.

Breda frequently attends Rabbi Simon’s weekly shiurim. His example and specific advice about kidney donation helped Breda frame her thoughts to share with her children and her parents, Anne and Jack Mermelstein, and her sisters, Ruchi Tiger and Malki Bernstein, who were all supportive and there for her and her family during her hospital stay and beyond. Breda also read the book, “A Kidney Donor’s Journey,” by Bergenfield’s Rabbi Ari Sytner, which she found useful in helping her to formulate her decision.

“A lot of people think at this age that they should wait, wait until the children are out of the house, or whatever. There are so many reasons that ‘right now’ is not a good idea,” Breda said. But then she considered the life of her recipient, who she assumed, is waiting “right now” and doesn’t have the option or luxury of doing anything else.

“There are so many people ‘waiting’ for a kidney. But what I realized is, and what Rabbi Simon said is, ‘Don’t wait to do a mitzvah.’ We don’t know what’s going to happen later. Do it now. Do it while you can. Do it while you’re healthy and your family is healthy.”

“I have three wonderful children and of course the thought crossed my mind—why now? Maybe it’s better to wait until they’re older, once they’re all grown up and it’s the right time. But the answer kept coming back, why not now? Why wait to do this mitzvah? Will there ever be a right time? And what an incredible example to set for my children—the ultimate chesed, giving someone else their life back. For me this was my right time.”

The Road to Kidney Donation

Breda and her husband are friends with Lauren and Zvi Adler; Zvi donated his kidney in 2017 to his father, Rabbi Yosef Adler, mara d’asra of Congregation Rinat Yisrael in Teaneck. At Rabbi Adler’s well attended seudat hoda’ah (meal of thanksgiving) in November 2017, the Bredas sat for an hour at the Renewal table giving out forms and helping people swab to see if they were a match for someone in the Renewal database. Breda decided to swab as well.

A few days later, she received a call from Renewal, and while her heart skipped a beat, it turned out to be a staff person calling to evaluate whether she was truly serious about donating her kidney, as the cost to process each swabbing kit is high and the organization only wants to begin the matching process for truly serious candidates. Breda said she would think about it, but didn’t call back at that time.

About a year later, Breda still had “the call” in the back of her mind. A thought from that seudat hoda’ah had stayed with her. A speaker at the event, kidney donor Estee Stark, met her recipient that evening for the first time, and got a chance to look at her, embrace and share a moment of thanksgiving. Stark shared a thought with the assembled group that she had come to understand as part of her process. Breda said, “She said something like, ‘Hashem gave us two kidneys; one to use and one to give away.’ That thought stayed with me as I learned about how kidneys function. You can live perfectly fine with one working kidney, but if one kidney fails they both do. I never knew that.”

Last year Breda returned that call to Renewal, secure now that she wanted to move forward with additional testing, but her swab couldn’t be found. She had to repeat the swab kit test, mailing back a Q-tip with saliva taken from inside the cheek, and then proceeded with what has become known as “the million dollar physical,” at Cornell, that is used to evaluate the health and fitness of kidney donors.

Breda completed blood work, psychological evaluations, nephrology exams and interviews with many health professionals, including the hospital’s transplant coordinator. Hospitals want to ensure that the donor is completely altruistic and that no one is pressuring donors to donate. They also want to make sure the donor is stable enough to understand that they cannot control the recipient’s medical outcome or anything else, such as regret if a close family member may later need a kidney.

At that point, only she and Ben knew that she was going through the process, but as they inched forward and identified her match, she was then given the option of scheduling her donation. She arranged time off from her work as a self-employed event planner and personal shopper, and took the big step of telling her parents. Having secured their enthusiastic support for her decision, she arranged for them to be in town from Florida to stay with her kids. “It’s all on your terms, because the donor has to be stable and well enough to have the transplant as well. If the donor has to delay, the recipient can go on dialysis to stay in good shape for the transplant.”

Lessons Learned

Recovery from a kidney donation is different for everyone. In Breda’s case, her surgery went flawlessly, but she had a reaction to the anesthesia that left her abdomen uncomfortably bloated. “I was warned about certain kinds of gas pain radiating to the shoulder, for example, from other donors, who began to arrive one by one, or in small groups, to the hospital before and after my recovery.” She also appreciated a special visit one night from her sisters, Ruchi who lives in Bergenfield, and Malki from Riverdale, who helped her wash her hair and kept her walking up and down the corridors, that tried-and-true remedy that many C-section moms remember, to help reduce abdominal bloating.

Breda spent five days in the hospital, on an outpatient type of private floor of the hospital, and then was told to expect up to eight weeks of recovery until being 100% back to herself. Every kidney donor is treated to their own room and as many amenities as possible.

The constant parade of visits from donors to Breda’s hospital room was transformational for her. “In hats, beards, payos, wigs, secular, chasidish… they don’t care [what I looked like], and they wanted to visit me and wish me a refuah sheleima (a complete recovery). They looked in my face, spoke to me as an equal, with incredible kavod (honor), and they all asked me for a bracha (blessing).

“At first I thought, ‘they are asking me for a bracha? I didn’t understand. A Sqver chasid is asking me for a bracha?”

Rabbi Josh Sturm, Renewal’s director of outreach, explained why donors ask other donors for a bracha. “A donor once went to one of today’s big gedolim (rabbinic leaders), introduced himself as a kidney donor and asked for a bracha. ‘You’re asking me for a bracha?’ the gadol said. ‘I should be asking you for a bracha,’” Sturm related. He added that a Renewal staff member serves as an administrator of a donor WhatsApp group, and visits to new donors among this group are enthusiastically coordinated there, so that the hospital room is never too full nor too empty, and each donor is welcomed into their ranks with joy.

Breda was initially confused, even confounded by the heterogeneous group of Jews visiting her. “Then I realized. I have become part of a group that transcends outward Jewish labels. The labels that outwardly separate Jews from one another are not present with kidney donors. All are holy. I am so proud to have this commonality of people who feel that saving a life is the most important thing a Jew can do.

“The respect goes both ways. I respect them in the same way they respect me. It is the most awe-inspiring group of people, and becoming part of it is the most life-changing thing I have ever done. Renewal has sparked something in the Jewish community that transcends physical barriers,” she said.

The Jewish community, Breda added, is the first community to have taken to altruistic kidney donation enthusiastically so far. Catholic, African-American and even military-veteran communities have piloted or researched similar programs, but not yet with Renewal’s success. Renewal’s kidney donations, said Rabbi Sturm, now account for more than 18% of all altruistic kidney donations nationwide.

Breda’s donation is the 18th transplant to stem from the Teaneck community since 2017. A total of 25 donors today have come from Teaneck and the surrounding communities since Renewal began working here in 2014. Renewal, formed in 2006, has completed 606 transplants as of this writing. Breda is the 597th person to come forward as a Renewal donor.

Renewal provides comprehensive resources and assistance to those who need a kidney and covers all costs to those who donate, including lost wages, babysitting and transportation. Testing and hospital fees are covered by the recipient’s insurance. The donor pays nothing.

Those seeking more information can visit https://www.renewal.org.

By Elizabeth Kratz