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Johns Hopkins leads first 12-patient, multicenter 'domino donor' kidney transplant
Date:2/17/2009

Surgical teams at The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis and Integris Baptist Medical Center in Oklahoma City successfully completed Saturday the first six-way, multihospital, domino kidney transplant. All six donors one man and five women, and six organ recipients four men and two woman are in good condition, according to Robert Montgomery, M.D., Ph.D., chief transplant surgeon at Johns Hopkins.

The procedure, kidney paired donation (KPD), takes a group of incompatible donor-recipient pairs (recipients coming to one of the three hospitals with a willing donor who is not compatible by blood or tissue) and matches them with other pairs in a similar predicament. By exchanging kidneys between the pairs, it is possible to give each recipient a compatible kidney. In this way each recipient receives a kidney from a stranger and transplants are enabled that otherwise would not have taken place. Involving multiple hospitals created even more possibilities for matches.

In Saturday's so-called domino swap, a surgical team made up of nine surgeons, six anesthesiologists and 12 nurses began a cross-country set of operations with five incompatible pairs. An altruistic donor and a recipient who was next on the United Network for Organ Sharing (UNOS) organ recipient list started and ended the domino. Altruistic donors are those willing to donate a kidney to any needy recipient.

Just like falling dominoes, the altruistic donor kidney went to a recipient from one of the incompatible pairs, that recipient's donor's kidney went to a recipient from a second pair and so on. The last remaining kidney from the final incompatible pair went to the UNOS recipient.

As part of this complex procedure, Johns Hopkins flew one kidney to Integris Baptist; Integris Baptist flew one kidney to Barnes-Jewish and Barnes-Jewish flew one kidney to Johns Hopkins.

"We have performed a six-way domino procedure at our hospital befor
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Contact: Eric Vohr
evohr1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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