Ex-inmate's death gives diabetic crucial transplant

JACKSON, Miss. — When Kristi Pennington Shanks, 29, started a prison ministry called A New Beginning to ease inmates' transition back into society, little did she know that a 24-year-old former prisoner — who took his life three weeks after his release — would give her a new beginning as well.

Since her diagnosis with type 1 diabetes at age 12, Shanks had struggled with a disease that was destroying her body.

"By the time I was in high school, I had nerve damage in my organs and outer limbs," said Shanks. Usually you have diabetes for 30 or 40 years before you get to that."

Shanks was warned that having a child could be risky, so when in 2010 she found out she was pregnant she braced for the worst.

"I had been taking preventive measures for that not to happen, so it was a shock," she said. "I was scared thinking of Steel Magnolias, but had faith that everything would be OK."

Although Shanks said her blood sugar was well-controlled during gestation, the pregnancy took a toll on her body.

"I developed pre-eclampsia," Shanks said, referring to the condition that causes high blood pressure and can damage the kidneys.

After delivering a healthy daughter — Sawyer, now 3 — Shanks' hypertension worsened. The following January, she noticed swelling in her ankles and legs.

"My blood pressure remained high, even though I was on a lot of medication to control it," she said.

"She could barely put one foot in front of the other," recalled her mother, Glenda Pennington of Brandon. "Just getting out of bed was a challenge."

Still, Shanks moved forward with life and a career that had led from teaching elementary school to working for Rankin County Sheriff Bryan Bailey.

It was with Bailey that she founded A New Beginning.

"She did so much for me and all the trusties," said Tommy Wallace, 36, of Brandon, a former inmate. "There were so many times she put aside her life and her struggles for us."

Sustained hypertension and diabetes can damage kidneys, and when a biopsy revealed end-stage renal failure, Shanks was told she would need dialysis or a transplant within five years.

Scared and confused, she prayed for guidance and was led to the Diabetes Foundation of Mississippi.

Mary Fortune, executive vice president of the foundation, has lived with type 1 diabetes herself for more than 40 years and had become close to Shanks since her diagnosis in 1998. Increasingly alarmed by Shanks' deteriorating condition, Fortune contacted friends in the medical profession.

"As Kristi's problems managing diabetes arose, we were able to recommend a specialist she could see at the University of Alabama at Birmingham," Fortune said.

When Shanks' kidneys failed, Fortune introduced her to transplant surgeons in the region — including Dr. T. Mark Earl, assistant professor of surgery and director of the pancreas transplant program at the University of Mississippi Medical Center.

Because she was in good health except for her kidney and pancreas, Shanks was a good candidate for a kidney/pancreas transplant, said Earl, a member of the board of the Diabetes Foundation of Mississippi. "She had done a great job of taking care of her diabetes."

A new pancreas would not only cure that diabetes but also protect the new kidney.

"Without replacing the pancreas you may still get recurrent diabetic damage in the new kidney," Earl said. The kidney/pancreas procedure "increases the life of the kidney and the life expectancy of the patient."

That said, the procedure carries risks — including immunosuppressive therapy and the possibility of rejection. For that reason, a pancreas transplant is rarely recommended for those who do not need a kidney, as well.

While Shanks' brother and cousin were transplant matches, she was advised that a kidney and pancreas would last longer if they came from the same donor. A pancreas must come from a cadaver, so Shanks opted to wait.

"I wanted to get both organs from same person, even if I had to be on dialysis for a while," Shanks said. "Plus, if I ever needed another kidney I would have my brother and cousin."

Shanks showed the kind of determination that can make the difference between years on dialysis and quickly finding a match, Earl said. "She was smart and listed herself at multiple centers, optimizing her chance of getting transplanted quickly."

Shanks was listed at the University of Mississippi Medical Center in late 2013, just as its burgeoning kidney-pancreas transplant program was established.

Shanks was also listed at UAB, and just a week before needing dialysis — the day after her 29th birthday — a late-night call came from Birmingham.

Doctors had found a match, but there was one caveat: Because the donor had been released from prison just three weeks before committing suicide, there was the minor risk of an undetected infection.

"It is not unusual to have donors that have been incarcerated," said Shanks' surgeon, Dr. Carlton Young, director of pancreas transplantation at UAB, who said long waiting periods underscored the urgent need for more kidneys.

"Historically, if testing comes back negative the risk of infection is extremely low. But we do alert patients."

"It was a heavy decision to make," Shanks said. "But I immediately thought, 'Yes, I want it, because I had been working with prisoners. That was my sign from God that it was meant to happen.' "

After the operation, the new kidney and pancreas began working beautifully, and Shanks' life, which had been so difficult for so long, was renewed.

Said Shanks, still marveling: "Before the transplant I was taking 52 pills a day, plus shots once a week for anemia."

Growing up she had been on a half dozen or so injections a day, then transitioned to a pump, all the while having to stick her fingers every few hours for blood sugar checks.

Now diabetes was just a memory.

Shanks is again helping prisoners transition to life on the outside, and while she herself was confined in the hospital she received videos from grateful trusties.

"They said, 'We're so happy for you, we're praying for you, and we're ready for you to come back,' " she said.

Wallace, the former inmate and now a construction worker, said he had one regret.

"I was released about a month before Kristi got her transplant, and as happy as I was, I was also sad because I wanted to be where I could still hear from her. Almost made me wish I was still in jail."

Said Kristi's mother, Glenda Pennington: "We feel like this ministry has come full circle to bless Kristi. This young man's donation has saved her life."

"I have yet to write the donor's family," Shanks said. "I don't think thank you is enough. But at the same time it's all I know how to say."