Organ donation in Israel: Sharing the good - opinion

‘Everything in my life is overflowing with blessing – I feel a need to share it’

 KIDNEY DONOR Naama with transplant recipient Eliran. (photo credit: DAVID ZEV HARRIS)
KIDNEY DONOR Naama with transplant recipient Eliran.
(photo credit: DAVID ZEV HARRIS)

Naama Ullman Alfasy has seven children and one kidney. She recently gave the other kidney away to a stranger.

Naama is a young friend, 47, the youngest daughter of a close friend closer to my age. I was with them both plus Naama’s husband, Gilad, as she was wheeled into the underground operating theater at Hadassah-University Medical Center in Jerusalem’s Ein Kerem. 

I’ve known Naama since she was a little girl. I recruited her – a National Service nature guide and later a student at a religious seminary – as the perfect coach for my daughter’s bat mitzvah projects. Although I know that the overwhelming majority of kidney donors recover with minimal complications, I share their jitters.

I catch up with Naama a month later to ask how she’s feeling and to ask what I couldn’t that day: why she decided to undergo the surgery. It’s a busy Friday when she’s been out for a run, and getting ready for Shabbat in Nehusha, a community south of Jerusalem in Mateh Yehuda. She finds time.

“Everything in my life is overflowing with blessing,” says Naama. “I felt a need to share it. Thank God, we’re all healthy: my husband, our parents, our children and me. I’ve been inspired by the many stories of altruistic donations. Somewhere in my mind the question was buzzing – So why not you?”

A model of human kidneys. (credit: MCT)A model of human kidneys. (credit: MCT)

Although she can’t pinpoint the moment when the decision was final, a turning point may have been the death of a severely challenged boy in their community. “I was so sad at the thought that he was gone and there would be no continuation of him on earth. His parents donated his organs, and I had a sudden moment of inspiration that I would donate my kidney in his memory, too.”

ONCE UPON a time it was rare for Israelis to donate organs, in life or after death. But thanks largely to a nonprofit called Matnat Chaim, Hebrew for Gift of Life, Israel has moved up to No. 1 per capita in kidney donations. There were a mere 69 transplants a year in 2009, when Matnat Chaim was founded by the late Rabbi Yeshayahu Heber, a former school principal from Jerusalem who gave up his day job to promote live transplants, making matches for kidney disease patients and donors. Since then, the numbers have quadrupled.

A kidney recipient himself, the saintly Rabbi Heber died early in the pandemic from COVID-19. His wife, Rachel Heber, continues his work. 

I subscribe to the Matnat Chaim email list, which elicits prayers for donors and recipient. I’m always overwhelmed by the courage of the donors. Since Naama’s surgery, there have been an amazing 25 such surgeries.

A long process of medical and psychological tests precedes acceptance as a donor.

“I thought of it as a pregnancy with its built-in tests,” Naama says.

The hardest part was with the notoriously tough committee to make sure she was acting out of altruism.

“It was like a conversion court where they try to elicit your doubts and discourage you,” she says.

She passed.

Like the vast majority of donors – an estimated 90% – Naama is an Orthodox Jew. Recipients come from all religions and religious streams. Gender-wise, she’s in the minority. Two-thirds of the donors are men. She fits the profile for profession – more than 40% of the donors are educators.

A teacher and music therapist, Naama has now transitioned to becoming a therapist and program director of the Sheffer Institute, which provides family guidance and therapy. As she’s a specialist in couples therapy, I wonder how her husband, Gilad, an actor and producer, reacted to her decision.

“He was the easiest one,” she says. “Without pausing, he said he thought it was a worthy decision and would help in any way I needed. We didn’t share it with our children until I passed the tests and my donation was a reality. The older children wanted to know the risks, but were supportive. The younger children were afraid I might die, and needed reassurance.”

And then came the part she feared most: telling her mother, my friend.

“I called my brother for encouragement,” she says. “What did I learn? My sister-in-law was also in the donor program!”

It was husband Gilad who helped her frame the explanation of her decision. He knew that Naama’s parents would ask why she couldn’t find alternative ways to do good deeds. He said she should see herself as volunteering for a “commando unit.” A brother is an IAF navigator, and every time he’s in the air they feel a mixture of fear and pride.

And that, says my friend, is exactly what they felt as Naama was wheeled into the operating room.

She knew only that the recipient was a man in his thirties.

THE RECIPIENT, Eliran Argaman, is indeed 36. Although he never knew of anyone in his family with Familial Mediterranean fever, his pains and frequent temperature spikes were diagnosed as that genetic immunological disease in 2009, about a year after he married Lior, the love of his life. They learned that the disease would destroy his kidneys, that he would need dialysis and ultimately a transplant. The dialysis was so exhausting that his boss in his hi-tech firm switched him to a desk job.

Lior, realizing they could pass on the disease, agreed to undergo IVF. While her husband began dialysis, Lior has undergone numerous rounds of IVF.

Last October, through Matnat Chaim, a donor was found. There was a delay because of a bout of COVID-19 in Naama’s family.

And so, on February 20, after both surgeries, they met for the first time in Hadassah Medical Center.

Says Naama, “How did I feel? I was overcome with embarrassment. It made me very uncomfortable to have two people so grateful to me. I felt an instant bond and admiration for Lior, who married without any thought of her husband getting so sick a year into their marriage and having to undergo IVF to avoid passing on the disease. I thought to myself, This was for you, Lior.

“You see, in my village, there are two women who run a project to provide food for the needy. Most people do some of the cooking, but the two of them are in charge, organizing, taking turns, making sure everyone gets food week after week, holiday after holiday. That’s a commitment. What I did was a onetime donation, and I’m feeling fine.”

Transplant surgeon Abed Khalilah, who removed Naama’s kidney and planted it in Eliran, tells me that a transplant is far more than a technical procedure. “It’s a sort of spiritual transfer, when you remove a living organ, hold it gently in your hands, watch it become part of another body and start to work. It’s a sacred process.”

And, as Naama would say, it’s a joy to pass on blessings. 

The writer is the Israel director of public relations at Hadassah, the Women’s Zionist Organization of America. Her latest book is A Daughter of Many Mothers.