In a medical first, a transplanted kidney rejected by one patient was successfully transplanted into another patient, according to doctors at Northwestern Memorial Hospital in Chicago.
Twelve years ago, Ray Fearing, 27, of Arlington Heights, Ill., was diagnosed with focal segmental glomerulosclerosis (FSGS), a rare disease characterized by the buildup of scar tissue on the kidney. Most often found in young adults, the disease prevents harmful chemicals in the blood from filtering through the kidney.
When his disease worsened in April 2011, he was placed on the kidney transplant waiting list. His wait would not be long, just two months, after his younger sister, Cera, 21, stepped up right away to try to save her big brother.
"Before I even asked her she was ready to volunteer" her kidney, Ray Fearing said.
"It was very exciting," he said. "I'd been looking forward to it for a long time."
During routine kidney transplants, the new organ that is placed in the recipient rarely shows signs of recurring disease. But in patients with FSGS, there is a 50 percent chance that the transplanted kidney will also develop the disease.
Fearing was on the wrong side of those odds. Within two weeks of the transplant, surgeons removed his new kidney.
"I was making all these plans for the future because I would have a new kidney," said Fearing. "I was distraught and very wounded by the whole experience."
But instead of discarding the kidney -- which is routine in the event of a failed transplant –Northwestern Memorial Hospital surgeons, with Cera Fearing's consent, decided to give the kidney another chance.
For the first time, doctors successfully re-implanted the so-called damaged kidney in another patient. Once the kidney was removed from Ray Fearing, it began to show signs of recovery from damage caused by its short-lived exposure to FSGS.
Within a few weeks, the kidney restored itself and was fully functioning in the new recipient, 67-year-old surgeon and father of five, Erwin Gomez.
"We proved for the first time that the disease is reversible in an organ once it's taken out of the body," said Dr. Lorenzo Gollan, a transplant nephrologist and medical director of the kidney transplant program Northwestern Memorial Hospital in Chicago.
This procedure challenges the idea that surgeons can only attempt to transplant an organ once, said Gollan, whose findings were published in the New England Journal of Medicine.
"Instead of removing the organ and throwing it away, if you have a good surgical background to reconstruct the vessels, you can put the kidney in someone else and it can work," said Gollan.
More than 92,000 Americans are on the waiting list for a kidney transplant, and nearly 3,000 new patients are added to the list each month, according to the National Kidney Foundation. In 2011, nearly 17,000 Americans underwent a kidney transplant.
Although transplants take place when a match is found between a donor and recipient, in some cases -- as in Fearing's -- there's still a chance the transplant may not be successful, Gollan said. But recycling the transplanted kidney will give more recipients a shot within an already limited donor pool, he said.
"It will increase the donor pool, which needs to be increased anyhow," said Gollan.
Fearing was put back on dialysis and will have to wait at least a year before another transplant attempt can be made.
"I'm excited to be a part of this, even though it didn't work for me," said Fearing.
The road ahead for Fearing is complicated by the fact that the chance of his disease damaging another new kidney is even higher than 50 percent, Still, Fearing says he remains optimistic.
"I'm convinced that I should be hopeful," he said.