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Organ transplant and stem cell transplant in the same family

Pielavesi in Northern Savonia is home to a grateful couple who are perhaps the only one of their kind in Finland. Both have been given a new chance at life, thanks to organ and tissue transplantation. Juha was saved by an unknown stem cell donor while Kirsi received a new kidney.

Midsummer in Pielavesi, the birthplace of Urho Kekkonen, is perhaps not quite at its best as. Although there is plenty of greenery, an unusual chilly spell has frustrated many holidaymakers. However, Kirsi and Juha Rajasuo are not complaining.

“It does not matter to us whether it rains or shines, whether the summer is like this or not. For Juha and me, the main thing is that the next morning comes at all“, Kirsi says.

The couple’s journey together has included both spouses falling seriously ill. Kirsi, 49, developed chronic kidney disease as early as in her late teens, leading to renal failure over the years. The progression of the disease was successfully slowed down with medication and diet for many years, and at the age of 22, Kirsi became a mother to the couple’s daughter.

It was not until her daughter was a little over ten years old that Kirsi’s condition deteriorated so that she had to undergo dialysis. By then, it was clear that before long she would need a new kidney. The daughter was entering puberty around the same time and, according to Kirsi, the year preceding the transplant was chaotic.

“I may not have wanted to admit that I would have to be treated. But I did not know at the time that our family would later face something even worse“, Kirsi recalls now.

Kirsi got a souped-up kidney

In the end, Kirsi only had to wait two months for the organ transplant. She is not sure about the donor, but in her heart she has a hunch.

“The night before the operation, I heard on the radio that there had been a major, fatal motorcycle accident in Southern Finland. Since then, I have believed that that person is my organ donor. Perhaps because the doctor said after the operation that ‘you got a really souped-up one’”, Kirsi laughs.

“Many people seem to have a story or an idea about where their donated organ has come from; maybe it is then somehow easier to accept it as part of yourself”, says Kirsi, who has been actively involved in the operations of the Finnish Kidney and Liver Association.

Kirsi recovered well from the operation, the new kidney undertook its task diligently, and the family lived a normal life for many years. They were working hard, renovating the house, building a summer cottage and travelling.

Two stem cell transplantations

The husband Juha, 51, has always been keen on sports with almost all the ball sports in his repertoire.

“Floorball, volleyball, badminton, rink bandy and also gym training”, Juha lists.

For some time, his excellent fitness level also covered the first signs of illness, which began to emerge in the autumn of 2013. Despite the sports and working out, he was tired and did not feel at all rested after a holiday.

“Coworkers noticed that I was not okay, but I just went to the gym to train even harder“, Juha says.

The following spring, Kirsi noticed a lump above Juha’s clavicle, which he went and showed to a doctor. A couple of years earlier, Juha had already had a couple of other lumps on his neck that had been found to be harmless. Now, however, the situation was different, and the family received shocking news before the summer – follicular lymphoma, or lymphoid cancer. It had already spread to the armpit and groin and filled almost half of the bone marrow.

Aggressive cytostatic treatment started immediately. The disease responded well to treatment and the cancerous tumours began to get smaller. The drug therapy lasted for about a year, and Juha even returned to work as a carpenter for a few months after the end of the treatment.

Soon, however, there was another shock. The disease reared its head again. It was then decided to do a stem cell transplant with Juha’s own cells. In autologous stem cell transplantation, the patient’s own healthy bore marrow stem cells are harvested prior to aggressive drug therapy aimed at destroying the cancer cells. The stem cells are then returned to the patient’s bloodstream where they find their way to the bone marrow to produce new, healthy cells.

The transplant was done, another year passed, and everything looked great. It was the summer of 2016. Until one day, Kirsi was rubbing her husband’s neck and found yet another new lump.

“It was horrible, such a terrible bombshell that I too had to take two days of sick leave”, says Kirsi, who works as an immediate supervisor in services for the elderly.

“I thought that this cannot be true. But yet again we quickly went in for an examination.”

It soon became clear that the only chance to get better would be a stem cell transplant from a healthy donor. Juha himself has had a fighting attitude the whole time.

“All this time I have said that I will not give up, that I will see this through.”

Family and friends have been invaluable

Two suitable donor candidates were found in the world’s stem cell registers for Juha. However, there was still one big obstacle to overcome. As traditional drug therapy had ceased to be effective against Juha’s cancer and the disease had to be under control as much as possible before the transplantation, the doctor decided to try a completely new type of cytostatic in Finland for the first time. The risks were enormous, but Juha endured through the treatment. So he got to the transplant – almost.

“The first transplant was postponed at the last minute because Juha had the flu. At that point, I was almost overwhelmed with grief”, Kirsi recalls.

“I thought, what if something happens and the donor is no longer available for a second time. That waiting period was terrible.”

There have also been sources of joy. Family and friends have been invaluable, and at the last, worst stage of the illness, Juha and Kirsi became grandparents to now 3-year-old grandson, Lenni. When it was time for the stem cell transplant, the couple decided to move from their large detached house into a terraced house residence. While Kirsi and Juha were in Helsinki for treatment to prepare for the stem cell transplant, the couple’s friends renovated the home so that it would be nice to return there and settle down.

Two weeks after the first attempt, the transplant that saved Juha’s life became possible. Even though he was quite a frightening sight as he battled a post-transplant fever, it was a very desirable reaction indicating that the foreign cells were starting to work.

Daily life has settled down

In July 2019, Juha and Kirsi are both doing well. Juha has not had any complications, and he visits the Kuopio University Hospital every four months for a check-up.

The only thing that Juha knows about the person who saved his life is that he is a man. Juha has himself been an active blood donor back in the day, and many of the couple’s friends have started to donate blood after what took place. A number of friends, his sister and daughter have also joined the Stem Cell Register.

“Donating stem cells shows so much love for one’s neighbour that words are not enough to tell how grateful we are. That someone just wants to do it from the goodness of their heart”, Kirsi says with emotion.

There are some new things in Juha’s life now. Aside from the changed hair colour, the immediate circle also sees other changes.

“According to our daughter, dad has learned to talk and cook. Maybe it is not really due to the cells, but we do think that he, who used to be a little shy, is now much more open and social”, Kirsi says.

Even though Juha had a small dip in spirits about a year after the transplant, a more melancholy period, daily life has settled down. Juha could no longer return to his hard work as a carpenter, but Jerry the dog forces him to go on walks and he cycles in nature with the dog. Cycling has become an important hobby for Juha after the stem cell transplant. This form of exercise was a good start to getting fit after taxing treatments. He has also returned to ball sports, although the pace has slowed down a bit.

Anybody might need a donor

“Juha’s case shows that even a young, fit person can get cancer. Therefore, we sincerely hope that young healthy people would stop to think about these things sometimes in the middle of their active lives. You can really help a lot by expressing your will to donate organs, joining the Stem Cell Register or donating blood. And the recipient may sometimes be your own child, sibling or even you yourself.”

Juha would like to emphasise that joining the Stem Cell Register does not mean that you are making any definitive commitment yet, even though that is certainly desirable.

“Even if you join the register, you always have a chance to refuse when summoned if the situation is not right for you for some reason at the time.”

Kirsi and Juha are now living a normal life with all its joys and sorrows. The couple, who like travelling, have already taken two trips to Greece.

“What do we expect from the future? Being able to live like this, and more trips! We need nothing more as long as we can live like this and keep our health as it is.”

Playing drums, which he started as a teenager, is a very important hobby in addition to exercise. Juha tours the surrounding area with his band PopMuseo whenever possible. Photo: Eemeli Kiukkonen

Original text: Iira Hartikainen