“It’s a privilege to share this journey with people” … Tomica Gnjec, a kidney nurse transplant co-ordinator at Canberra Hospital. Photo: Michelle Kroll.
James Rucska has received the gift of another person’s kidney not once … but an incredible three times.
The 55-year-old Queanbeyan resident is hoping his third kidney transplant, which he underwent in March this year, “will see me through the next 40 years”.
“I’m lucky, but I guess I’m also unlucky,” he says.
James was 20 when a big night out for his birthday turned into what he thought was a mildly annoying but persistent flu.
A welder at the time, he was young and fit, but took himself off to the optometrist when his vision “went funny”. Retinal photos revealed something more sinister and he was sent straight to hospital.
“I started dialysis just like that,” he says.
As it turned out, James had an autoimmune disease, IgA nephropathy, that was damaging his kidneys. His life came to revolve around a dialysis machine at Canberra Hospital three days a week for four to five hours each time.
“It has such an impact on your life,” he says. “I hated dialysis – I wanted to put my foot through that machine. It’s a love-hate thing. You need it but you don’t want it.”
James was on a waitlist for more than three years before his first transplant, which took place in November 1993 at Sydney’s RPA Hospital.
While Canberra offers specialist renal care services and helps facilitate organ and tissue donation through DonateLife, no actual organ transplants are performed in the ACT.
That first transplant process was both “an eye-opener” and a game changer for James, who was able to return to work and study but admits the recovery process can take many months with a strict regime of self-care and medication.
It’s not simply a case of pop in a new kidney and you’re good to go, he says.
“I was so thankful, I was able to get back to a better lifestyle,” James says. “But it is not a cure, it’s just a better form of treatment.”
Then there’s the mental recovery of coming to terms with the fact that someone has to die so that you can live, he says. James is aware of the fact his first kidney came from a young girl, about six or seven years old, who died in an accident.
“I think about that a lot – you certainly look at things with new eyes,” James says.
James Rucska has received the gift of another person’s kidney not once, but an incredible three times. Photo: Supplied.
Devastatingly, his condition saw the first kidney begin to fail in 2004 and he was back on the dialysis treadmill again for another three years before a second transplant in August 2007.
“That transplant lasted until 2022,” he says cheerfully.
By then he had become all too familiar with the crippling symptoms that would plunge him back on to dialysis and a wait-list for the third transplant.
James says his new kidney is “running well” but the worry is always on his mind and he’s meticulous about things like nutrition … and mindfulness – of “keeping up that inner smile”.
“You have to stay positive,” he says. “You want to safeguard this kidney that’s not yours and when it does fail, you do think ‘Have I done a good enough job?’.”
Canberra Hospital kidney nurse transplant coordinator Tomica Gnjec is acutely aware of the complexities of that journey.
A nurse of 30 years, she has done the “full circle” when it comes to organ donation and transplantation – from the intensive care unit where she witnessed the courage of “precious organ donors and their loved ones” to her most recent role supporting those who have received the “incredible gift” at the other end of the donation process.
As the community prepares to come together on Sunday 16 November to say thanks to the generous Australians and their families who make donation possible, Tomica says it is an honour to work in this space.
On DonateLife Thank You Day 2025 she will hold close the five words she associates with organ donation and transplantation – Courage, Resilience, Honour, Hope and Respect.
Every days she sees those words in action for those living with end stage kidney disease and the team of wonderful kidney doctors, dieticians, exercise physiologists, podiatrists, diabetes specialists and educators who support them.
While transplants offer a unique and precious treatment opportunity for an improved health journey, freedom and quality of life, Tomica says it’s hard to comprehend the enormity of even getting to that stage.
“Many people describe it as a lottery – and in a way it is,” she says.
Currently there are about 1800 Australians waiting for a life-saving transplant and an additional 14,000 people on dialysis, reports DonateLife.
In the ACT and South Eastern NSW catchment, there have been 21 transplants this year, according to Tomica.
Before even getting on a wait-list, individuals need to complete a thorough health screening process and “transplant work-up” – that process can take as long as 12 months and involves a huge personal, physical and emotional investment, she says.
Transplant surgery typically occurs in Sydney and a hospital stay can range from seven to 10 days to up to three months, depending on how smoothly things go, according to Tomica.
“I guide people on the return home after transplant,” she says. “We usually see people twice a week in our kidney clinic, carry out blood tests, check wounds and provide support and education – not only to the patient but also to those around them.
“Navigating post-transplant health is a big commitment and it can be challenging to navigate and adapt to a new normal – from lifestyle changes to appointments, medication and even relationship adjustments.”
Sometimes it’s just about being available for a chat – and Tomica’s absolutely ok with that.
“Most people grab this incredible opportunity and say I’m going to make the most of this new lease of life,” she says.
“But as much as we talk about organ donation, unless you’ve been through the process it’s hard to comprehend the enormity of this gift you are receiving.”
Learn more about organ donation and Thank You Day at DonateLife
