Esther Gaines holds her wedding photo. (Sept. 28, 2010)

Esther Gaines holds her wedding photo. (Sept. 28, 2010) Credit: Newsday / Alejandra Villa

Esther and Arthur Gaines thought they had finally found their miracle.

The Rockville Centre couple, married 44 years, had been elated when they learned that Esther, 63, would be able to donate her kidney to her 65-year-old husband.

Arthur Gaines, a retired Medicaid management analyst, had suffered from failing kidneys for about four years and was facing dialysis.

"I was my husband's only option and it was an amazing surprise that I was a match," she said.

The couple successfully underwent surgeries at NewYork-Presbyterian Hospital/Columbia University Medical Center last Wednesday, but less than 48 hours later, Arthur was dead from cardiac arrest, his family said.

"I went to the hospital a wife and came home a widow," Esther Gaines said this week. About 10 percent of living kidney donations come from a spouse, according to the Organ Procurement and Transplantation Network.

Gaines' daughter, Lauren Zimmerman, 38, of Sacramento, said Esther's kidney was re-transplanted into a 36-year-old man on dialysis from the metropolitan area.

"That was comforting," Lauren said. "At least it was something."

The family has said that the hospital should have put Arthur, who repeatedly complained he couldn't breathe after the surgery, on a heart monitor.

NewYork-Presbyterian Hospital/Columbia University Medical Center would not address any specifics of Gaines' care.

In a statement, the hospital, renowned both as a transplant and heart center, said: "We deeply sympathize with the family on the loss of their loved one. Due to patient privacy regulations, it would be inappropriate for us to discuss specifics regarding the care provided. However, we can tell you that we are undertaking a complete and thorough review."

Gaines said that last Thursday - a day after the operation - her husband felt as though he couldn't catch his breath.

"He told me, 'I'm having trouble breathing. Can't you get someone to help?' " she said.

He was placed on a nebulizer to help him breathe, said his daughter, but it did little to help.

Gaines said she last saw her husband alive around 10 p.m. last Thursday as he complained - yet again - through an oxygen mask of his struggle to breathe. She then rubbed his hand and kissed him good night.

"He had another life ahead of him," said his son, Jonathan Gaines, 41, of Los Angeles. "He has four grandchildren that he won't watch grow up."

Cardiac arrest, heart attacks or strokes - although unexpected - are a chief cause of death following a kidney transplant, experts said.

"What happened at Columbia could happen at any transplant center," said Dr. Wayne Waltzer, chief of the transplant program at Stony Brook University Medical Center.

Even kidney transplant patients who don't manifest signs of heart disease are at higher risk for a cardiac event, said Dr. Stacey Rosen, associate chair of cardiology at Long Island Jewish Medical Center in New Hyde Park.

That is partly because of the inherent risk of surgery and partly because there are many high-risk conditions - such as diabetes or high blood pressure - shared between end stage kidney disease and cardiovascular disease, she said.

Nonetheless, statistics show most kidney transplant recipients - who otherwise face dialysis or death - do well.

Among those 65 and older who got a kidney from a living donor, the survival rate at three months was 96.9 percent, according to 2008 statistics from the Organ Procurement and Transplantation Network, the national transplant network established by Congress. At one year, it was 94.4 percent. About 10 percent of living kidney donations come from a spouse, according to the network.

Gaines said her husband was kept alive on a respirator until early Tuesday to ensure her kidney would go to someone who needed it, so that her husband's last gesture was the gift of life.

And, if given the chance, she would do it all over again.

"I would still donate," she said.

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