Making a sacrifice for a friend

Phil Ponsolle is an organ donor.

That’s both the condensed version of this story and one of the many factoids about the State College resident readily available on his driver’s license, along with his hair color, height and weight.

The decision most likely presented itself as an extreme hypothetical, a gesture of blind generosity in the face of a speculatively tragic demise, reduced to a box on some form at the DMV.

Whatever his reasoning, Ponsolle made a choice that he knew would benefit one of the countless people across the country in need of an organ transplant, an abstract crowd of faceless strangers that he would never meet.

Until one of them sent him an email.

Clean living

Because this is Thanksgiving and not Halloween, the guy on the other end of the email most definitely had a face — and a familiar one at that.

Joe Varano went to high school with Ponsolle in West Chester. It was the type of friendship that you just kind of fall into at that age, but they were close enough to know the highlights from one another’s biographies.

In Varano’s case, it was more like a medical textbook.

At just 5 years old he started experiencing problems with his kidney, an inflammation and scarring of the organ’s filter cells that was later identified as nephrotic syndrome.

In 1985, Varano underwent his first kidney transplant. He was 13 years old.

Even as a young boy, Varano knew that the surgery provided only a temporary reprieve. Most donated kidneys last between 10 and 12 years and he wasn’t sure that there would be another one waiting for him at the end of the line.

“I actually had a very grim outlook,” Varano said.

What little control he did have over the situation was executed with a diligence and attention to detail that has long since become second nature.

Even lunch, for example, isn’t always a picnic.

Substances like salt, potassium or even proteins can place a strain on the kidneys if they aren’t kept in check.

For the most part, Varano eats whatever he wants — pizza, potato chips, etc. — but he does keep a watchful eye on the size of his plate.

The immunosuppressants that he’s required to take also impose a few restrictions on his day-to-day life. For starters, any cuts or bruises he receives heal very slowly — and one of his main hobbies is martial arts.

Varano avoids the homes of friends with small children, chubby-faced germ delivery systems carrying any number of potential illnesses that the medication hampers his body’s ability to fight.

It’s a lot to be mindful of at any given time, but when your life depends on it, you make allowances.

“I probably know kidney health better than I know my profession,” Varano said.

The borrowed organ has lasted him nearly 30 years and only recently began to show signs of decline during Varano’s regular checkups.

His nephrologists finally recommended that he initiate the steps toward another kidney transplant.

“I had been putting it off for as long as I could,” Varano said.

The next step

Phil Ponsolle had to think.

It was September and he had been one of many people listed on an email that Varano had sent out to friends explaining his situation and need for a new kidney.

Ponsolle felt compelled to help, but there were other considerations — primarily splitting up a dream team of kidneys that had worked so well together these many years.

“You’ve got to wonder what are the chances of something going wrong,” Ponsolle said.

Ultimately, that didn’t stop him from being one of the nine people who responded to Varano’s message and offered to undergo the medical tests necessary to initiate the donation.

Ponsolle was placed first on the list by the sheer virtue that he happened to know his own blood type.

Urine was tested, chest X-rays and blood work performed, even an EKG — all indicating the same thing.

Ponsolle was a suitable match.

The tenets of supply and demand dictate that this all should have been very simple — and in the end, for Ponsolle at least, the decision to part ways with one of his kidneys was pretty straightforward.

“If he’s not going to survive without one then the decision is almost made for me,” Ponsolle said.

Ponsolle has two kids, a 14-year-old son and a 9-year-old daughter who live in Mifflin with his ex-wife. On the weekends they like to play video games and do crafts together.

He said that his son is mostly comfortable with the idea of the procedure, while his daughter is more worried. She’s afraid that being down one kidney will leave him “squishy” and impair his ability to be hugged.

If there’s one thing that he would like them to take away from all of this — and its not like he has a lot of other organs left to spare — it’s the sanctity of friendship.

“You have to take care of your friends and sometimes you have to make a sacrifice,” Ponsolle said.

The procedure

Varano is part of a clinical trial at Northwestern Memorial Hospital in Chicago and if everything goes according to plan, he may emerge from this transplant with a fully functioning immune system.

But first, they’re going to have to kill it.

A week before the procedure, Varano will undergo chemotherapy and radiation treatments. At that point, stem cells will have already been harvested from both Varano and Ponsolle, which the doctors will then use to bridge the gap between two different immune systems.

Varano’s body would be less inclined to view Ponsolle’s kidney as a foreign invader, allowing him to be slowly weaned off of the immunosuppressants.

“I’ll actually heal at regular speed again,” Varano said.

Getting ready

The transplant is expected to take place in late February or early March in Chicago and it’s possible that the weight of the impending procedure has not yet landed on Ponsolle.

“I’m sure as we get closer to the surgery I’ll get more nervous,” Ponsolle said.

Right now he’s focused on being thankful for two happy and healthy kids — which is fine. True to form, Varano is already on top of the nitty-gritty details.

He helped establish a crowdfunding page on GiveForward.com to raise money for Ponsolle’s transportation, lodging and food in Chicago.

At first blush, Varano’s attentiveness to every nuance of the procedure, from air travel to patient care, appears to be a natural outgrowth of his sincere belief that people should be actively involved in their own health, but it could also be interpreted as a measure of his gratitude for the enormity of the sacrifice that Ponsolle is making.

“He’s saving my life, literally. There’s no other way to put it,” Varano said.

This story was originally published November 25, 2015 at 4:27 PM with the headline "Making a sacrifice for a friend."