Gift of transplant bonds two strangers

McClatchy Newspapers (MCT) - Robb Culp believed God was leading him to donate a kidney to Carlos Esqueda even though the two Fresno, Calif., men were virtual strangers who had only one thing in common: an uncommon faith.

Culp teaches chemistry at Fresno City College. Esqueda used to sell illegal drugs. Esqueda, an extrovert, comes from a big boisterous family, while the introverted Culp was adopted and doesn't know much about his birth family.

Theirs is a story of Christian love, of two pasts haunted by trouble and a deepening bond of brotherhood.

"I've never met any man like Robb," said Esqueda, 48. "He laid down his life for me."

Culp, 53, said he had come to a point where his relationships with others and his faith in God mattered most. "When I die, I will have at least touched one person in a real and tangible way," he said.

However, as Culp stepped forward to help Esqueda, each man faced questions. How could Culp be sure it was God leading him to undergo an operation that would leave him with a 5-inch scar below his navel? And why did Esqueda need Culp's sacrifice when he had siblings who might have been donors?

You could say that Culp's decision to donate began when his first wife died after Thanksgiving in 1999.

The Culps returned from the holiday weekend at a relative's house and got into an argument. "We went to bed angry and I didn't say, 'I love you' or 'We'll talk about it in the morning,'" Culp said.

He awoke in the middle of the night to the sound of her gagging. Culp called 911. Paramedics came. But Johanna Culp died. The Fresno County Coroner's Office said the cause was complications of heart disease.

Culp said he was devastated.

"She was good _ simple as that," he said. "The rest of my life I could never tell her that I was there for her. The rest of my life I could never tell her that she was a treasure."

Culp, who later remarried, said he decided he would never again ignore a chance to help another person.

Esqueda passed Thanksgiving 1999 under far different circumstances. He was in state prison on drug charges _ the culmination of a dissipated life that began in his teenage years and continued for two decades.

He partied. He used drugs. He got married, divorced and didn't pay much attention to his two sons. "I wasn't there for them as a father," he said.

Esqueda was in and out of the Fresno County Jail several times on drug and other charges, had a jailhouse conversion to Christianity, but got involved in drugs again and landed in state prison in 1998.

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He broke his mother's heart, and she often cried over his troublesome ways.

Four years in prison gave him time to look inside himself, he said: "The Lord made me think about a lot of things."

He got out of prison with stronger faith, but a weakened body. He had high blood pressure.

He said he took medication to control the problem, but then stopped _ believing incorrectly that he was cured.

In 2006, Esqueda wound up in a hospital emergency room, where doctors said his two kidneys were functioning at 10 percent of normal. The organs' failure was allowing toxins to build up, which made Esqueda sick and could have killed him.

Esqueda blames the untreated high blood pressure for damaging his kidneys _ which could be the case. However, Dr. Sang-Mo Kang, a surgeon and member of the Culp-Esqueda transplant team, said there are many causes of kidney disease and that doctors don't know what triggered Esqueda's illness.

Esqueda said he used methamphetamine before going to prison, and research shows the drug can increase blood pressure.

After his trip to the emergency room, Esqueda started dialysis treatment, but he wasn't always the best patient _ sometimes eating rich, greasy foods that added to his problems.

Dialysis left him listless and drained, and there were complications with a shunt implanted in his chest to aid with dialysis, Esqueda said. He sometimes talked about his problems at a Thursday morning men's breakfast and Bible study in Easton, Calif., a community of about 2,000 southwest of downtown Fresno.

Culp attended, too, but the two men were not friends.

"These are two people who would never have met in a million years," said the Rev. Paul Demant, pastor of the Lutheran church that hosts the breakfast. "They live in different worlds."

Culp sat at the breakfast with his friends from the Presbyterian church; Esqueda usually was across the room with his father and a pastor from a small Pentecostal congregation.

One Thursday in November 2007, the usually gregarious Esqueda sounded depressed as he gave a progress report about his health at the breakfast. It was as if the reality of being hooked to a dialysis machine several days a week for the rest of his life had struck him with painful clarity. He needed a kidney.

Esqueda could have survived many years on dialysis. However, the treatment takes a toll on the body, and the risk of death increases with time, Dr. Kang said.

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Culp said he listened to Esqueda, and seemingly out of nowhere a thought came to him: I should donate a kidney. He went home and told his wife, Jane, who thought at first that her husband was kidding. She said she quickly became supportive because she believed that her husband was listening to God.

Culp, who describes himself as analytical, wanted to make sure he wasn't acting on emotion. He said he saw no point in asking other people what they thought. "I was looking to hear from God, not other people's point of view," he said.

For five months _ from late 2007 into the spring of 2008 _ Culp uttered the same prayer: "Lord, I need to know this isn't my whim; that it's something I'm supposed to do."

Culp got a response, but not in words he could hear. Instead, he said, the answer came in a growing conviction that God's will would be revealed by events soon to play out. All he had to do was wait.

Meanwhile, Esqueda chose to believe God would help him as, one by one, the people closest to him said they couldn't give him a kidney. He said he asked his three brothers and sister to donate; each declined. Some had health problems of their own or feared surgery, he said.

"In the long run, we can't stop God's plan," Esqueda said. "By my family not giving me a kidney, it gave Robb a chance to donate."

At the time, though, he was hurt by his siblings' decisions, he said.

However, siblings are not automatically compatible kidney donors, said Kang, the surgeon. "There is a better chance than if the donor is random, but there is no guarantee," he said.

As Culp was praying whether to donate, Esqueda was experiencing physical and emotional pain. One day, he said, he dropped to his knees in his bedroom, where he had two pictures of Jesus on the walls and a silver-and-black Oakland Raiders football atop his television set.

He cried for several hours and prayed: "You know, God, that I've been waiting patiently." He asked for relief from his suffering.

Culp was nearly ready to talk to Esqueda.

One morning in May 2008 at the men's breakfast and Bible study, Culp stood in line to get scrambled eggs. He tapped Esqueda on the shoulder and said, "I want to test for you."

Tests would show whether Culp was a compatible donor. Perhaps the results would reveal whether God was leading him to donate.

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Esqueda said casually that he would find out what Culp needed to do, but his mind shouted something else: This is from God!

Others didn't understand. "Man, that's pretty crazy," Esqueda's brother, Armando, said.

Blood tests revealed that Culp and Esqueda were, indeed, compatible for a transplant.

Esqueda, who had been on a transplant list for more than one year when Culp approached him, could have waited many more years to receive a kidney, Dr. Kang said.

Once Culp's compatibility was confirmed, he went through a battery of medical tests at the University of California at San Francisco. The transplant operation would take place at UCSF Medical Center. He was found to be in good health. A social worker interviewed him to make sure he was psychologically sound.

The two men began to know one another better during those pre-surgery trips to San Francisco. They talked about God, the Bible and family. Culp said he even came to appreciate their differences: Where he obsessed over details of the transplant, Esqueda didn't fuss or fret.

A deep friendship took root.

"Our relationship isn't through a kidney," Culp said. "Our relationship developed because of a kidney."

On Sept. 18, Esqueda and Culp were wheeled into surgery. Kang made four half-inch incisions in Culp's abdomen to surgically free one of the kidneys. The surgeon then made a horizontal incision so he could remove the organ.

It went immediately into Esqueda. KFTV (Channel 21) in Fresno filmed in the operating rooms for a special report on the two men that the station plans to broadcast in March.

Culp came through the surgery fine, Kang said. It's one of the safest operations, although there's always risk with surgery, he said.

Culp's long-range prognosis is good, because research shows that people who donate a kidney aren't at higher risk of developing kidney disease, Kang said.

The transplant operations cost about $300,000, which Esqueda said was covered by his Medi-Cal and Medicare insurance. Culp said he paid about $2,000 to cover expenses for him, his wife and Esqueda on trips to San Francisco. Members of the men's Bible study also gave Esqueda travel money.

After recuperating for eight weeks, Culp returned to teaching at City College in November. Esqueda, who stopped working as an auto detailer when he got sick during dialysis, has not gone back to work. He gets regular checkups, and he said his new kidney is functioning well.

Since the operation, their relationship has become so comfortable that Esqueda doesn't bother to knock when he comes over to Culp's house. The two men take long walks in the country, and Culp throws his arm around Esqueda's shoulder without thinking.

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The quiet Culps and boisterous Esquedas spent Thanksgiving and Christmas together. "Now they're part of the family," said Esqueda's brother, Armando. "Robb's a giver, that's for sure."

A year ago, Culp and Carlos Esqueda had not had a meaningful conversation. Now they consider themselves brothers.

Said Culp: "God put Carlos in my path for whatever reason, and I couldn't see myself turning my back on him. I don't ever want to be in the situation where I say, 'I should have.' I want to be uncompromising in that."

Esqueda, less analytical and more outgoing than his friend, says, "God saved me because he has a purpose for my life. What it is, I haven't figured out yet. I'm still searching. But I found a friend I never had."

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© 2009, The Fresno Bee (Fresno, Calif.).