KIDNEY OPERATION RUNS AFOUL OF U.S. OFFICIALS.

Byline: Carolyn Jung Knight-Ridder Tribune News Wire

Four times a day, starting as early as 3 a.m., Virgie Frias hooks herself up to a dialysis system to cleanse her blood of impurities, a task her failing kidneys can no longer perform.

The 42-year-old San Jose woman would be spared this with a kidney transplant. Her younger brother, a perfect match, has agreed to donate one of his kidneys. But Jerry Revestir lives in the Philippines, where the U.S. Embassy is particularly strict with visas because of a high level of fraud. And because U.S. officials are skeptical that Revestir will return to his homeland after an operation, they have denied him permission to come here.

In her condition, Frias cannot endure a 15-hour flight to the Philippines to have the operation performed there. And if her brother cannot journey here, Frias, whose sole working kidney only functions at 5 percent capacity, would be put on a long waiting list for a live organ donation.

Now, Frias just waits and wonders what will happen next.

``I'm upset,'' she said. ``But I can't do anything.''

Bruce Byers, acting public affairs officer for the U.S. Embassy in Manila, said he was not familiar with Revestir's case but would review it. He explained how difficult it can be to obtain a visa there.

``Because of a high incidence at this post of fraud and forged documents, our people have to be very careful, and, yes, skeptical,'' Byers said in a phone interview. ``If there's the least bit of suspicion that the person won't return, U.S. law requires the visa applicant be rejected.''

Byers said the use of phony birth certificates and other bogus identification is so rife there that it is one of the few U.S. Embassies that maintains an anti-fraud office.

Immigration is extremely backlogged for Filipinos because so many want to come to the United States and only 27,558 are allowed in each year. As a result, they face a 10- to 15-year wait.

It's unlikely those applying for immigration would risk their status by committing fraud, Byers said. Instead, the bulk of the forgery occurs with applications for other types of visas, such as tourist ones that are good for a 90-day visit.

The doctor who would have supervised the transplant said he recalls three cases in the past few years involving donors in the Philippines. Each case was ultimately resolved, said Dr. John D. Scandling Jr., but almost all of them took multiple interviews and doctors letters.

``The embassy has a tough job; I can understand where they're coming from,'' Scandling said. ``We haven't had anyone turned down, yet. Sometimes it takes some work, some persistence, though, on the relative's part.''

Frias said she met a San Jose man at church one day, whose brother in the Philippines tried to come here to donate a kidney to him but faced similar hurdles.

``His brother wasn't allowed to go,'' said Frias, a customer service representative who immigrated 11 years ago. ``In fact, he told us not to even bother trying because we would be turned down, too.''

After Frias' blood count dropped so low in September that she had to be hospitalized for 2-1/2 weeks and begin dialysis, Stanford University Medical Center doctors performed blood tests on her siblings to determine if they were compatible donors.

The best match turned out to be her 28-year-old brother in Santa Cruz Lezo Aklan, a province south of Manila, who has the same blood and tissue type as Frias. Revestir, who has been waiting 10 years to immigrate and whom Frias hasn't seen for six years, is the only family member still left in the Philippines.

Unlike heart or liver transplants, a kidney transplant is considered an elective procedure, not a life-saving one. But the quality of life does improve for the patient because dialysis no longer would be necessary. Some studies also have shown that patients who have the transplant live longer, particularly if the donor is a good match, said Scandling, StaInford's medical director of renal transplantation.