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Doctors Hope ‘Kidney-Swapping’ will Save Lives
by
findingDulcinea Staff
Responding to a donor shortage, doctors at several hospitals are coordinating kidney-swapping, in which healthy people exchange kidneys with strangers to help an ailing loved one.
30-Second Summary
Often a patient in need of a kidney transplant will look for a donor among friends and relatives. That search frequently produces willing benefactors whose good intentions are frustrated because these potential donors are medically incompatible with the intended recipient.
Now doctors at several U.S. hospitals, including Johns Hopkins Hospitals and New York-Presbyterian Hospital/Columbia University Medical Center, are choreographing a non-profit trade between kidney donors who are trying to help someone dear to them.
In this scheme, a donor who is incompatible with the donee can look to a pool of people in the same situation in order to arrange a swap.
This paired exchange is expected to provide a boost to the 6,400 kidney transplants that occur each year and shorten the transplant waiting list.
According to the United Network for Organ Sharing, which maintains the national waiting list for organ transplants, 73,771 people are in line for a new kidney. Some of them will wait for as long as five years.
The lack of organs has created a global “black market” in kidneys. So far, Iran is the only country in the world to legalize this trade.
Now doctors at several U.S. hospitals, including Johns Hopkins Hospitals and New York-Presbyterian Hospital/Columbia University Medical Center, are choreographing a non-profit trade between kidney donors who are trying to help someone dear to them.
In this scheme, a donor who is incompatible with the donee can look to a pool of people in the same situation in order to arrange a swap.
This paired exchange is expected to provide a boost to the 6,400 kidney transplants that occur each year and shorten the transplant waiting list.
According to the United Network for Organ Sharing, which maintains the national waiting list for organ transplants, 73,771 people are in line for a new kidney. Some of them will wait for as long as five years.
The lack of organs has created a global “black market” in kidneys. So far, Iran is the only country in the world to legalize this trade.
Headline Links: What is kidney-swapping?
Dr. Robert Montgomery, a Johns Hopkins surgeon, organizes kidney-swaps. Such exchanges must occur simultaneously between two or three pairs of recipients and donors. The Wall Street Journal explains how the kidney-swap works: “The healthy member in each couple would donate a kidney -- not to his or her own spouse, but to a stranger who is a medical match.”
Source: The Wall Street Journal
In a kidney-swap, the two or three transplants it involves are synchronized so that donors cannot back out. "If it weren't like this, I could give my kidney up and the other donor could just walk out and not go through with it," Ms. DeCample one such donor explained.
Source: The New York Times
Background: Function of the kidneys, kidney donations
Kidneys are bean shaped organs located in the middle of the back below the rib cage. They filter approximately 200 quarts of blood each day, and produce 2 quarts of urine. Without this filtering process, waste would build up in the bloodstream and damage the body.
Source: Kidney and Urologic Diseases Clearinghouse
According to the United Network for Organ Sharing Web site, 97,858 people are on the waiting list for a organ transplant in the United States and of those 73,771 people are waiting for a kidney. From January to July 2007, there were 16,758 organ transplants.
Source: United Network for Organ Sharing
The National Kidney Foundation explains the two types of kidney donations: living and non-living. One of the benefits of a living donation is that a kidney from a living donor usually functions immediately, while kidneys from a non-living donation do not always function right away and the patient may require dialysis until the kidney begins to function.
Source: National Kidney Foundation
Related Links: Altruistic donations, “extreme” kidney transplants, organ sales
A kidney-transplant surgeon at the University of Toledo hopes to shorten the kidney waiting list by creating a “never-ending altruistic donor chain.” Altruistic donors are willing to donate a kidney, but have no recipient in mind. Dr. Michael Rees encourages these benevolent individuals to give a kidney to someone who has a willing donor with whom they are medically incompatible. The willing but mismatched donor then gives a kidney to another mismatched couple– and this chain continues.
Source: The Wall Street Journal
In early October Doctors from Wake Forest University Baptist Medical Centre, in North Carolina, presented a study to the European Society for Organ Transplantation that supported the use of “extreme” kidneys, kidneys that normally would be discarded by surgeons. Such kidneys include functions that are less than perfect and that come from elderly people. The study followed patients with “extreme” kidney transplants and regular transplants and found the former had performed as well as the latter.
Source: The Economist
While some proponents argue the “black market” of organ sales could be regulated if legalized, opponents contend such legalization has not stopped the black market in Iran, the only country to legalize the sales of organs.
Source: Radio Free Europe Radio Liberty
Reference: Assistance for donors, national waiting list
The National Kidney and Urologic Diseases Information & Clearinghouse offers a directory of voluntary, governmental and private kidney and urologic diseases organizations.
Source: National Kidney and Urologic Diseases Information & Clearinghouse
The 2004 Organ Donation and Recovery Improvement Act (U.S.) provides assistance to living donors with travel, subsistence and incidental non-medical expenses.
Source: Transplant Living
The Organ Procurement and Transplantation Network offers comprehensive information for people waiting for kidneys, including recent laws passed concerning organ donations and it lists transplant centers by organ and by state.
Source: Organ Procurement and Transplantation Network
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