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OSU Medical Center Accomplishes 6-Way Kidney Transplant

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Posted: 9/9/2011

COLUMBUS, Ohio – A synchronized chain of six kidney transplants resulted in an ideal match for three women and three men at The Ohio State University Medical Center this week. The swap of kidneys between the 12 patients required two days to complete and more than two months to orchestrate.
The six-way, single-institution transplant is the first and largest to date in Ohio and one of only a handful that have taken place in the United States.
The circuitous path taken to achieve the six transplants is a silver lining to the recipients who earlier had faced uncertainty in their quest for the surgeries due to medical incompatibilities between them and their originally intended donors.
The donors and recipients are recovering following the transplants that took place on Tuesday and Wednesday of this week.
The chain of transplants began with an altruistic donor who stepped forward to donate a kidney to a recipient who was a part of one of the incompatible pairs. That recipient’s intended donor then provided a kidney to the recipient in the second pair and the swaps continued through to the sixth recipient. The sixth recipient did not have an intended donor and had been waiting for a cadaveric kidney to become available.
Multiple transplants, such as a six-way transplant, are uncommon due to the logistics involved in screening pairs of incompatible donors and recipients in hopes of finding matches that can benefit each person. However, when there is success in the matching process, the manner in which the donors fall into alignment with compatible recipients in succession gives the procedures the nickname of domino transplants.
Transplant surgeon Ronald Pelletier, who led the series of transplants, says Ohio State University Medical Center and other transplant centers around the country constantly look for ways to maximize the limited pool of donors.
“We have many more people on the waiting lists for organ transplants than we have people willing to donate,” said Pelletier. “Frequently we face issues of incompatibility between candidates and potential donors where tissue and antigens aren’t necessarily the correct match and a transplant would not be safe.”
Pelletier said this series of transplants took months to pull together. “We’ve performed smaller ‘swaps’ in the past, but there is real satisfaction in pulling together six transplants that initially seemed like they would never occur.”   
The Medical Center’s efforts to arrange the six-way transplant began in a laboratory where the tedious task to match the donors with potential recipients was conducted. Nicholas DiPaola, assistant director of the histocompatibility lab at Ohio State, says searching the donor and candidate lists to create a chain of compatible donors and recipients takes time and patience. “We have computer software that is designed exclusively for this purpose, but double-checking and communicating to the patients and donors about the options of a 6-way donation took some time.”
The recipients of the six-way transplant initially did not know the identity of their actual donors and the donors did not know to whom their kidney was transplanted, but that changed Thursday when the patients had the opportunity to be united with their match.
“This extraordinary effort by staff at our Medical Center demonstrates the power of the altruistic donor selflessness and the collective good of organ donation and transplantation," added Dr. Robert Higgins, director of Ohio State’s Comprehensive Transplant Center.
For nearly four decades, the OSU Comprehensive Transplant Center has been a national leader in the field of transplantation. Ohio State performs kidney, liver, kidney/pancreas, pancreas and heart transplants.
Approximately 100 medical professionals including doctors, nurses and support personnel took part in the 12 surgeries that lasted an average of 2-3 hours each. Surgeons assisting Pelletier were Drs. Ginny Bumgardner, Elmahdi Elkhammas, Amer Rajab and Mitchell Henry, chief of the division of transplantation.
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For additional information about Ohio State’s organ transplant program, go to: http://www.medicalcenter.osu.edu/patientcare/healthcare_services/transplant​
Contact: David Crawford, OSU Medical Center Media Relations, 614-293-3737, or Crawford.1@osu.edu
Transplant; OSU Medical Center