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The Alliance for Paired Donation announced that the first three-state kidney exchange occurred on July 30 with patients in North Carolina, Colorado, and Alabama receiving a living donor kidney transplant simultaneously.
The surgeries were made possible through the computer matching program offered by the Alliance for Paired Donation, a Toledo-based non-profit organization that seeks to shorten the waiting time for kidney recipients through kidney paired donation. Typically, paired exchanges match two pairs who each have a willing, but incompatible, living donor. Surpassing this, a 3-way swap was performed on July 30. The successful procedure involved rotating donors from four different states to three surgery locations so that the willing, but incompatible donors could be paired successfully with the patients in need, even though they couldn’t give directly to their loved one. In this case, a donor in Colorado flew to Alabama to give a kidney to a patient at The University of Alabama Medical Center in Birmingham, Alabama. That individual’s incompatible donor traveled to Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina, to donate a kidney to a waiting recipient. That recipient’s intended donor actually lived in a fourth state, so she traveled from New Mexico to the University of Colorado Hospital in Aurora, Colorado to donate a kidney to a waiting recipient, thus completing the three-way circle.
Michael Rees, MD, PhD, Medical Director of the Alliance for Paired Donation, said “Simple two-way swaps are pretty easy to arrange. This exchange was a bit more complicated because it involved three pairs whose recipients could not have found a match if we had only performed two-way exchanges. And the fact that each center is in a different state and time zone made the logistics more challenging.”
In order to accommodate the different time zones, the Wake Forest Baptist donor surgery was scheduled for later in the morning so that the Colorado surgery could take place at a reasonable hour. The transplant coordinators from all three centers were in frequent communication so that each knew when the donors were put to sleep and the surgery could begin. Paired exchanges generally are scheduled to occur simultaneously, so that no one backs out at the last minute.
Rees said “Our thanks go to the surgical and nursing staff at each of the hospitals – they worked together in harmony to make sure everything went as planned.” The transplant centers report all patients are recovering well. As of July 25, 76,615 patients were awaiting a kidney transplant in the US. In 2007, 16,626 kidney transplants were performed, and of those, 6,039 were from living donors. On average, 12 people die every day due to a lack of donated organs. Kidney paired donation has the potential to provide transplants for up to an additional 3,000 people per year. This would help alleviate the current waiting list crisis, because living donor kidneys last, on average, twice as long as deceased donor kidneys.
The Alliance for Paired Donation is headquartered in Toledo, Ohio. A 501 (c) 3 organization, the mission of the APD is to save lives by significantly shortening the waiting time for kidney patients through kidney paired donation. In its first full year of operation, the Alliance for Paired Donation facilitated 19 paired exchange transplants. Learn more about the program by visiting www.paireddonation.org, or by calling 419-866-5505.
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