NYC's first 3-way kidney transplant

Jun 26 2006

Six surgical transplant teams, including 40 clinicians, working simultaneously in six operating rooms successfully performed New York City's first three-way kidney transplant at NewYork-Presbyterian Hospital/Columbia. Three patients, who otherwise had no compatible donor, received lifesaving kidneys.

The multiple transplantations were made possible through the altruism of a 39-year-old Long Island man, who made the gift of life to a recipient unknown to him.

"Thanks to the altruism of one man and the extraordinary teamwork of our clinical team, three patient's lives have been saved," says Dr. Lloyd Ratner, director of renal and pancreatic transplantation at NewYork-Presbyterian/Columbia and professor of surgery at Columbia University College of Physicians and Surgeons.

In New York City's first three-way swap, the Long Island man's kidney was donated to a 55-year-old Warwick, N.Y., woman, whose husband donated his kidney to a 54-year-old New York City woman, whose brother-in-law donated his kidney to an 47-year-old Yonkers man. To ensure that the family member of the kidney recipient did not withdraw from donating after their loved one received a kidney, all donors underwent surgery simultaneously. Donors represented locations including upstate New York, Long Island and North Carolina.

"The kidney swap program not only makes more kidneys available, but it makes them available to patients earlier than they would have otherwise, helping to save lives," says Dr. David Cohen, medical director of renal and pancreatic transplantation at NewYork-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons.

The kidney recipients in the three-way kidney swap received their kidneys after a wait of up to two years, compared to an average New York wait time of six years. Thousands of people die each year while on the waiting list for an organ transplant.

Paired kidney exchanges (or "swaps") occur when willing and medically suitable living donors are found to be immunologically incompatible with their intended recipients (family members or friends). A search of the list of those awaiting kidney transplantation may reveal two or more such incompatible pairs, where the potential donor in one family—although incompatible with his or her family member or friend—is compatible with a different person on the waiting list who also happens to have a willing but incompatible donor. The donors then can each donate, but to the other intended recipient.

All kidney donors receive thorough medical and psychosocial screenings prior to being accepted as donors, and post-operative follow-up after donation. Evaluations include comprehensive testing to rule out any kidney disease or serious medical problems; potential donors must also be approved by a psychiatrist and social worker. Donors can expect a normal, healthy lifespan equivalent to what they would have experienced with two kidneys. After donating, the patient's single kidney compensates by growing larger.