Living Kidney Donation Chains May Help More Get Transplants

Mar. 12 -- WEDNESDAY, March 11 (HealthDay News) -- In 2006, one healthy young man stepped forward, willing to give one of his kidneys to a complete stranger. Two years later, 10 people had received new kidneys from that one remarkable altruistic act.

That's because his donation started the first nonsimultaneous, extended altruistic-donor (NEAD) chain. The woman who received the altruistic donor's kidney had a family member (her husband) who was willing to donate, but couldn't donate to his wife. So, he gave his kidney to a young woman whose mother was also willing to donate, but didn't match, and so on, and so on, until 10 successful transplants had occurred. The final donor in the chain is still waiting for a good match to someone in need of a kidney.

If all of this sounds complex and difficult to coordinate, it is. But, fortunately the doctors involved now have sophisticated computer programs to help them match possible recipients to willing donors.

"We've now transplanted 19 people through NEAD chains," said study author Dr. Michael A. Rees, director of renal transplantation at the University of Toledo Medical Center. "We've started six NEAD chains. The first one is 10 in length, the second is five," he said, adding that he hopes each chain never ends.

Details of the first NEAD chain are published in the March 12 issue of the New England Journal of Medicine.

Nearly 80,000 people are waiting on the transplant list for a new kidney, according to the Organ Procurement and Transplantation Network. Many of these people have a friend or family member who is willing to donate a kidney but can't because of a mismatch or other problem.

People can find themselves unable to donate to a loved one if their blood type doesn't match or if they've developed certain antibodies, which can occur through blood transfusions or in pregnancy.

But instead of turning those willing donors away, doctors came up with the idea of paired donation. In paired donation, two transplant recipients essentially swap their donors to make a good donor-recipient match. These operations are done at the same time, requiring four operating rooms, to assure that no one backs out once their loved one has received a new kidney.