Season of Giving: Altruistic Donor Leads to Chain of Four Kidney Transplants, All in One Day

Friday, December 11, 2009

PHOENIX — The generosity of a Phoenix woman who was determined to donate a kidney to anyone in need sparked the true spirit of the season — and the gift of healthy kidneys for four people, all in one day, all at one hospital.

In what is referred to as a "paired kidney exchange," the woman — an altruistic donor — led off the chain of events at Mayo Clinic Hospital on Thursday, Dec. 10. Her gift of a kidney initiated the trickle-down progression that allowed three other living donors to exchange kidneys on behalf of recipients who were in need of a compatible organ. In such a chain, the donors are not a blood or tissue match for their own loved ones in need of a kidney. The solution: The patients turn to donors — total strangers — who are a match.

A severe shortage of organs in the U.S. means that the average wait for a kidney transplant can be more than five years, according to Raymond Heilman, M.D., medical director of the kidney transplant program at Mayo Clinic. "As a result, nearly half of kidney transplants are from living donors," he said. But a problem arises when a potential living donor, while healthy and motivated to donate, is not medically compatible with his or her intended recipient.

With an altruistic donor (known as a "non-directed" donor because the medical center has permission to direct the kidney to any patient who needs it and is a match), that kidney goes to the needy recipient, and in turn, that recipient's donor donates to the next recipient — and the chain continues.

"This approach will allow for many more people with chronic kidney failure to get life-saving transplantation," explains Dr. Heilman.

The chain involved four donors and four recipients, marking the first "internal" exchange for Mayo, given that all of the patients were Mayo patients, and all of the surgeries took place under one roof, almost simultaneously. In many cases, kidney exchanges involve organs being exchanged among multiple medical centers to distribute compatible kidneys to recipients in need.

The milestone day, which began before 5 a.m. at Mayo Clinic Hospital, required eight surgeries, four surgeons, multiple operating rooms and teams of medical and administrative personnel. Importantly, carefully orchestrated plans were put in place to protect the privacy and anonymity of all donors and recipients.

The patients and family members were purposely kept separate to allow for privacy until such time that donors and recipients may choose to meet. In some cases, donors choose not to meet their recipients, and vice versa, while others make plans to meet once they are authorized to proceed.

All eight of the patients — donors and recipients alike — were reported to be doing well following the successful surgeries and are recuperating today at Mayo Clinic Hospital.

Nearly 85,000 Americans are waiting on a list for a kidney transplant. Thursday's kidney exchange contributed to there being four fewer people on that list.

To request an appointment at Mayo Clinic, please call
480-422-1490 for the Arizona campus, 904-494-6484 for the Florida campus, or 507-216-4573 for the Minnesota campus.

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About Mayo Clinic

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