- The Washington Times - Sunday, November 17, 2002

Thanksgiving comes every day for Dave and Sue Knight of Upper Marlboro: Their only child, Andrew who has clung to life since birth is studying youth ministry at Washington Bible College in Lanham.
Andrew should have died 16 years ago, when his single, poorly functioning kidney was to have been replaced with a healthy one. That transplant did not occur, and he survived by advances in medical technology and dialysis, as well as his parents' sacrifices and faith.
Today, the 18-year-old freshman owes his life to all those things but most of all to his high school English teacher, Bonnie Dukes, who gave him a gift as vital as his education and as personal as her health.
This summer, Mrs. Dukes gave her former student one of her kidneys.
Hers was an act of gratitude as much as generosity, an opportunity for Mrs. Dukes to say "thank you" to a man who had given her the gift of education and inspired her teaching career her former teacher, Dave Knight.
"He really influenced my life. He believed in me and helped me to find my feet," Mrs. Dukes says of Andrew's father, who taught her high school Bible class at Camp Springs Christian School when she was a teenager. "He was one of those teachers you don't forget."
Mr. Knight's influence on Mrs. Dukes, an English teacher at Grace Brethren High School in Clinton has come full circle to bear on his son.
"I'm willing to do stuff for people. As I look at what Bonnie did for me, she gave so much for me; I can do a little bit to help other people," Andrew says.

Andrew was born with only one working kidney, and it was functioning at only 65 percent efficiency. The kidneys help purge waste products from the body, and Andrew's weakly performing organ allowed for a buildup of toxins that was slowly poisoning him. Doctors said he would need a transplant before his third birthday, but progress in the treatment of renal disorders helped him grow into his teens without the transplant.
The typical medical strategy is to wait as long as possible before doing the operation "because of ongoing advances in transplant technology," says Mr. Knight, 50, an associate pastor at Grace Brethren Church.
During a church mission trip to Guatemala in the summer of 2001, Andrew grew seriously ill. Doctors discovered that his kidney was operating at about 20 percent efficiency. Expensive and lengthy dialysis treatments cleared many of the poisons and waste from Andrew's blood that his kidney could not.
The time for the transplant was drawing near, but there was one major obstacle: No one in his family was a viable organ-tissue match.
Mrs. Dukes, 36 and a single mother of two daughters, had been close to the Knights since Mr. Knight had taught her about the Old Testament, the Gospels and the Epistles at Camp Springs Christian School. In fact, she brought a rose to Mrs. Knight soon after Andrew was born.
She saw the anguish and anxiety the Knights were experiencing over their son's deteriorating condition and told them she would like to help. Compatibility tests revealed that Mrs. Dukes' blood type matched Andrew's.
The transplant surgery was set for June 24 at Children's Hospital in the District.
In the interim, Andrew went through his senior year at Grace Brethren High School with no serious complications. He played catcher on the baseball team, attended the prom and went on his senior trip to Orlando, Fla. all the while knowing he was to receive a unique graduation gift from Mrs. Dukes; a life-saving organ donation.

The transplant was scheduled for a Monday, and the Sunday before the surgery, Andrew and his parents went to church, then out to lunch before checking in at Children's Hospital. Andrew was put on intravenous fluids and was left alone to rest.
But he got a late visit from Mrs. Dukes, who was scheduled to have her left kidney removed at 8 the next morning across the street at the Washington Hospital Center. She brought a pizza to share.
"It was just to make that connection and to let him know that, whatever happens, I was with him," she says.
"We both knew that there's always an outside chance of complications, but I wanted to reassure him, and I was reassuring myself, too, that we were doing what we were supposed to do," says Mrs. Dukes, of Fort Washington. "We sat and laughed and talked."
The gesture was not lost on the Bible college student.
"It was kind of like a Last Supper sort of thing," Andrew says before amending his statement. "A last supper with my old kidney."
He had lived for 18 years with a slowly failing kidney, had been in and out of hospitals his entire life, and had fallen deathly ill the previous summer. But Andrew says he didn't really fear for his life until the morning of June 24, minutes before he was to receive his teacher's kidney.
"When they put me in that bed to wheel me down to the operating room, that was when it really kicked in, and I just wanted to get it over with," he says.
"I wasn't really nervous until that last hour," Andrew says. "I knew everything was going to be OK, but in the back of my mind there was this little thing that said, 'Maybe not.'"
By the time Andrew had begun to get jitters about the operation, surgeons at the Washington Hospital Center already had removed Mrs. Dukes' kidney, placed it in a cooler and hand-carried it to Children's Hospital.
Doctors worked four hours to put Andrew's new kidney in place and sew up their 12-inch incision in his lower abdomen, while the Knights sat anxiously in the waiting room with friends and other family members.
As they had done so many times during Andrew's life, the Knights prayed.
Dr. James C. Gilbert, pediatric surgeon and director of renal transplantation at Children's Hospital, eventually entered the waiting area and told them the kidney began to function as soon as it was placed in Andrew's body.
"It was such a relief to know that it was in and working and he had a chance for life," Mr. Knight says. "It was a joyous time."
"It was like this weight that I had been carrying around for the past year was removed," says Mrs. Knight, 50, an employee of the U.S. Census Bureau.
For much of Andrew's life, Mrs. Knight says, "I probably lived in not denial but in a world where I thought we had beat it. I thought he could live his life on the kidney he had."
"Last summer, when they said the time had come [to find a replacement], it was such a shock. I was afraid. I was really afraid, even though I knew that God was going to take care of it," she says.

On her first visit to Andrew's bedside, Mrs. Dukes noticed an immediate improvement in his color.
"It hit me that Andrew had been living for a long time with toxins in his body. When my kidney started functioning in his body, those toxins were being filtered out," she says.
Andrew, whose transplant was on a Monday, left the hospital that Friday two days ahead of schedule and the quickest recovery Dr. Gilbert says he has seen in his five years at Children's Hospital. "He broke the land speed record."
At the end of July, Andrew began to show some signs that his body was rejecting the new kidney, says Dr. Kanwal Kher, chief of nephrology at Children's Hospital and Andrew's nephrologist for the past decade. A change in Andrew's medications, which essentially disconnect his immune system to allow the kidney to work, corrected the problem.
Because his immune system could not protect his body from invading diseases, Andrew had to spend the first three weeks of his recovery sequestered in his parents' Upper Marlboro home, which had been scrubbed clean to rid it of germs. He was eager to return to his active, outdoorsy lifestyle but was forced into a sedentary, indoors routine.
His medications also increased his appetite. Unable to exercise but never missing a meal, he gained 18 pounds in the month after the operation.
"It was really getting to me a lot to not be able to get out of the house," he says. "There were days where I was real frustrated and angry that I couldn't be outside doing the things a normal person could."
In those times, "I went in my room and shut the door and prayed," he says.
Andrew returned to church for the first time July 21, overwhelmed to be among so many who had prayed for him for so long and "to get back to things and feel a little normal," he says
The Knights say the support they received from their church community was impressive. Andrew's girlfriend, Katie Vanderhoof, 17, even met a woman from Alaska at a youth conference in Kentucky who said she had been praying for Andrew after hearing about his illness "through the church grapevine."
Andrew's support system helped him recover quickly, Dr. Kher says.
"When you are dealing with an organ failure, it's not only medical care that matters," says the kidney specialist. "It's the support that you get at home and at school, with your friends, that is extremely important as well."
Although the average life expectancy of a donated kidney from a living donor is 15 to 20 years, Dr. Gilbert says, "We anticipate that Andrew will use that kidney for many, many years, and that he will never need another one."
Andrew, an aspiring youth pastor, says he has known "that God can take me home whenever He wants, but this has opened up my eyes to God's grace It's humbled me, but I'm just trying to move on and live a normal life."
And he and his parents daily thank his former teacher and his father's former student for giving of herself so that Andrew can live.
"It was an amazing thing to be a part of. I feel so blessed," Mrs. Dukes says. "I feel like I just did a little thing to make someone's quality of life so much better. It's something that I'll never forget."


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