5-way Kidney Swap Makes Transplant History

by Laura Miyashita

California Pacific Medical Center (CPMC) recently made kidney transplant history, becoming the first California hospital to perform a five-way kidney swap in a day-long series of operations. By the end of the day on April 4, 2011, five individuals had received living donor kidney transplants. "This was an incredibly complex procedure from both a surgical and logistical perspective," explains William Bry, M.D., surgical director of California Pacific's Kidney Transplant team and the lead surgeon in the procedure. "It involved five surgeons, four anesthesiologists, 10 nurses in the operating room, plus 40 support staff - all of whom played an important role in ensuring this was possible."

Donor Decision a "No-Brainer"

The five couples involved in the procedure came from throughout Northern California. Each couple included a patient in need of a kidney, and a spouse, partner or friend who volunteered to donate their kidney but was not a match. One donor, David Sidle, 44 of Santa Cruz, described the paired donor surgery as a "no-brainer." A difference in the antigens between him and his mom made a direct donation impossible. "The best outcome for my mom was to get a living donor," he said. By donating his kidney to someone else, he made that possible. "It's the same outcome for her, even though it's not my kidney," he explained.

Software Finds Matching Donors

In the past, kidney transplantation meant two options: an individual would have to find another donor who was compatible or wait for a kidney from a deceased donor. Now, a sophisticated "cloud-based" computer program called Silverstone Matchgrid™ has changed that. The program takes the individual characteristics of all those involved and generates a series of matches. Each donor is matched with a transplant candidate whom they don't know but is compatible. Matchgrid was created by David Jacobs, who developed the idea after undergoing a kidney transplant at CPMC. He realized that many potential donors were in effect being lost to the system because they weren't compatible with their friend or loved one. "Having almost died because of a lack of available kidneys, I wanted to do something to try and reduce the likelihood that would happen to other kidney patients," says Jacobs.

Positive Impact for Donors

The good news for donors is that giving up a kidney is unlikely to have any long-term impact on their health. "It's clear from research that healthy living donors don't have any change in their life expectancy after giving a kidney," says Steve Katznelson, M.D., medical director of CPMC's Kidney Transplant Program. "In fact, there may even be an improvement in the quality of life for donors because they get to see what a big impact their gesture has on the life and wellbeing of their friend or loved one. Without a living donor, these recipients would have to wait on the list for an average of four to seven years. In some cases they may never get a second chance at life."

In a day-long series of operations, 10 transplant surgeries occurred at California Pacific Medical Center, resulting in new kidneys for five individuals.

article published in Fall / Winter 2011Kidney Review newsletter