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Johns Hopkins leads first 16-patient, multicenter 'domino donor' kidney transplant
Date:7/7/2009

Surgical teams at The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Medical Center in Oklahoma City and Henry Ford Hospital in Detroit successfully completed the first eight-way, multihospital, domino kidney transplant. The transplant involved eight donors 3 men and 5 women along with eight organ recipients 3 men and 5 women. "All Johns Hopkins patients are in good condition and are recovering as anticipated," according to Robert A. Montgomery, M.D., Ph.D., director of the Johns Hopkins Comprehensive Transplant Center.

The procedure, kidney paired donation (KPD), takes a group of incompatible donor-recipient pairs (recipients coming to one of the four 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, but it also made the procedure more complex.

"We performed a similar six-way domino procedure involving three hospitals earlier this year," says Montgomery. "We managed to perform all those surgeries on the same day. However, adding two more recipients, two more donors and another hospital meant that we needed a multihospital team of eight anesthesiologists, 16 nurses and nine surgeons. The logistics being that much more complicated, we decided it was best to spread the surgeries over several days, the first on June 15 and the last, July 6."

Aside from sheer logistics, performing large numbers of transplants on one day puts a lot of strain on the doctors, nurses and staff at each hospital, says Montgomery, and also ties up too many operating rooms.

He says this new model will serve as a blueprint for a
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Contact: John Lazarou
jlazaro1@jhmi.edu
410-502-8902
Johns Hopkins Medical Institutions
Source:Eurekalert

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