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Sisters Share Unbreakable Bond Through Kidney Transplant Journey

Growing up, Amaris and Dominique Elston shared a profound bond, with their parents recalling moments when the two sisters were inseparable—always supporting each other through life’s challenges.

This close-knit relationship continued as they matured, and it was put to the test when Dominique, at the age of 18, was diagnosed with focal segmental glomerulosclerosis, a chronic illness that eventually led to kidney failure. Once again, Amaris stepped up to provide her sister with support.

“I told Amaris, ‘Dominique is in kidney failure. Her kidney function was at 19%, and she’s going to require a kidney transplant in the future,'” shared their mother, Denise Elston. “Within seconds, Amaris responded, ‘Can I give her one?'”

At the time, Amaris was in the midst of applying to medical schools and was aware of her family’s history with kidney disease, which led her to question whether she would be eligible to donate. Nevertheless, Dominique was determined not to let her sister’s life come to a standstill due to her illness. However, as Dominique’s condition worsened and her kidney function plummeted to just 5%—despite ongoing dialysis—Amaris made the decision to act without informing her sister. She underwent testing and ultimately discovered that she was a suitable match.

“She’s my little sister,” Amaris expressed. “As an older sister, it’s instinctive to want to protect her from every challenge, including health issues. I realized that this was the best path for her to regain control of her life and pursue her dreams. My decision was never really in doubt.”

Moving Beyond the Waiting List

Dr. Kelly Birdwell, medical director of kidney transplantation at Vanderbilt University Medical Center, which was not part of the Elston sisters’ treatment, noted that around 140,000 individuals currently wait for a kidney transplant in the United States. The average waiting period is approximately five years, and Black Americans are often disproportionately affected due to a variety of factors. Birdwell indicated that individuals with Type B blood—a group more frequently represented among Black Americans—face a lower likelihood of finding compatible donors. Additionally, the prevalence of kidney disease is higher in African American communities.

In a significant development, over 14,000 Black kidney transplant candidates were moved up the national waiting list in 2019 after studies revealed biases in a widely-used kidney function test that inaccurately portrayed the health of Black patients, extending their waiting periods.

Amaris was acutely aware of these dynamics when she chose to donate her kidney to Dominique. The year 2023 saw a total of 21,765 kidney transplants conducted, with living donors accounting for 6,294 of those cases. Among living donors, approximately 60% are related to the transplant recipients, Birdwell indicated.

The journey of becoming a donor begins with preliminary tests to confirm compatibility with the recipient. Following this initial evaluation, comprehensive health assessments, including blood tests and imaging, are necessary to ensure donor safety. If all requirements are satisfied, the surgery can be scheduled.

For the Elstons, this meant postponing the procedure until after Amaris completed her first semester of medical studies at the University of Alabama at Birmingham. In December 2018, both sisters found themselves waiting for their surgeries at the Vanderbilt Transplant Center, with Amaris undergoing her operation first. Birdwell estimates that the donor procedure takes about two hours, while the recipient’s surgery typically lasts three hours.

Once the sisters reunited post-operation, Amaris immediately noticed a remarkable difference in Dominique. “I was in a lot of pain, lying in bed, when Dominique strolled in like it was a normal day. That moment confirmed for me that my choice was right. She looked revitalized within 24 hours, full of energy and eagerness,” Amaris recalled. “It was worth every bit of the effort.”

Building Careers United by Experience

Amaris not only donated a kidney but also provided her sister with the opportunity to pursue a path in medicine. In 2022, Amaris graduated from UAB’s Heersink School of Medicine, and just two years later, Dominique proudly earned her bachelor’s degree in nursing from the same institution, while Amaris cheered from the audience.

Reflecting on her journey, Dominique said, “Going through this experience felt like a calling to enter the nursing field. It was a decision that came to me naturally—it felt destined.”

Both sisters have now embarked on careers in neurology; Amaris serves as a neurology resident at the Medical University of South Carolina, while Dominique works as a neurology intensive care unit nurse at UAB. They have become the first members of their family to enter the medical field, and while distance separates them by over 400 miles, their connection has never been stronger.

“It’s been incredible having someone by my side throughout everything,” Amaris shared. “I can openly discuss the highs and lows with someone who truly understands. We’ve navigated some of our darkest times together, solidifying a bond that only grows stronger with each journey we undertake.”

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