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Kidney Swap Gives Gift of Life to Four People in Four States

Yolanda Becker, MD, in transplant surgery
Yolanda Becker, MD, right, implants the kidney from a Good Samaritan donor.

Physicians at the University of Chicago Medical Center have long been interested in finding ways to get kidneys to the nearly 90,000 people in this country who need them.

In the late 1990s, the transplant team thought up a paired-kidney-exchange program for people who couldn't donate to a loved one because of incompatibility. The scenario would give Donor A's kidney to Recipient B, and Donor B's kidney to Recipient A.

Alas, perfect match-ups like this are hard to find, and the paired-kidney exchange stayed on the shelf for the next 14 years.

Yolanda Becker, professor of surgery and director of the kidney and pancreas program, recently resurrected the idea of a kidney swap at the University of Chicago. Her patient Ryan Braun needed a kidney, and all twelve of the people who offered to donate to him were incompatible.

"There is a subset of kidney transplant recipients who have a hard time getting a transplant," Becker said. "When we test their blood against potential donors, their blood reacts and they'll immediately reject the kidney."

Braun had been through a successful kidney transplant eight years ago. That kidney failed a few months ago, leaving him highly sensitized to foreign tissue.

But rather than say "no, thanks" to willing donors, Becker enrolled her patient on the National Kidney Registry. She hoped someone would match with him, so one of his donors could give a kidney to someone else in the same situation. Within days, she found him the right donor.

It was a Good Samaritan donor at Loyola University Medical Center, right across town.

Kidney being prepped for delivery to New York A donor kidney is prepared for delivery to a recipient in New York.

To get him the kidney, Braun's wife Tiffany donated on his behalf to someone else on the registry -- a recipient in New York. Someone donated on behalf of that recipient to a patient in New Jersey. Someone donated on behalf of that recipient to a patient in California. All these surgeries happened the same day.

"This collaboration across the city is wonderful," Becker said. "Transplant programs haven't typically interacted in this way."

The logistics of arranging a kidney chain stretching across the country are enormous. Kathy Davis, RN, kept track of the kidneys and patients moving around the hospital and across the country. "This is our first one," she said. "I have to make sure everything is lined up and goes as planned."

Davis watched Braun's new kidney come in from Loyola, planted a GPS tracker with the donor kidney before it was rushed to a plane, and ensured its safe arrival to New York.

Davis also offered steady reassurance to Braun and his family during a very long day of surgery.

"My first transplant was a miracle that was carried out with my sister-in-law and me in two ORs in the same medical center," Braun said. This chain, he said, was remarkable.

Kidney en route to New York The donor kidney leaves the Medical Center for delivery to New York.

Despite the grand coordination effort, Becker said the actual surgery was no different from any other. "The operation is the same. I just have to receive the kidney from an ambulance," she said.

At the end of the day, a total of eight surgeries gave kidneys to four people in four different states.

"It's an amazing act of generosity," Braun said of the people in the chain, giving kidneys to perfect strangers. "An unrepayable debt."

This kidney swap is the first of many at the Medical Center. Becker believes hundreds of people currently being treated for kidney problems at the hospital could be lined up with high-quality kidneys from willing donors.

"We're reaching out to people who had incompatible donors," she said. "Now we can tell them that we have this new program, with a new hope."

March 2011

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