Doctors Perform 3-Way Kidney Swap

B A L T I M O R E, Md., Aug. 4, 2003 -- In what is believed to be the world's first simultaneous "three-way kidney swap," three people saved their loved ones' lives, by donating their healthy organs to strangers who needed them.

Each of the donors originally wanted to help people they knew, but their blood types and tissues were incompatible. So kidney "matchmakers" instead managed to find six people who could help each other.

"As far as we know, this is the first time anyone's done a triple exchange," said Dr. Robert Montgomery, a lead surgeon at Johns Hopkins Hospital in Baltimore, where the surgery was performed July 28. "The idea is that you take pairs who are incompatible, recipients who are incompatible with their donors, and by swapping kidneys between them, you create compatible pairs, so each recipient receives blood-type and tissues that are compatible."

There have been fewer than 10 such operations in this country, involving donor swaps, with five done at Johns Hopkins. The matches are made with the help of a computer program. Four days after the surgery, the donors and recipients had an emotional meeting.

Mix and Match

Tracy Stahl, a 38-year-old waitress from Johnstown, Pa., was the centerpiece of the swap. She had hoped to receive a kidney from her 41-year-old sister, Connie Dick, from Latrobe, Pa., but ended up with the kidney of Julia Tower, 56, of Hyattsville, Md.

Dick gave her kidney to Germaine Allum, 30, of Coral Gables, Fla., who had anticipated receiving a kidney from her fiance, Paul Boissiere, also 30. And Boissiere's kidney was transplanted into 13-year-old Jeremy Weiser-Warschoff of Silver Spring, Md., who is the son of one of Tower's friends.

"It was amazing," Montgomery said. "Essentially, we had six operating rooms going on simultaneously throughout the day."

Stahl and her sister, Dick, were the first to come forward for a transplant.

Stahl had been on a waiting list for five years and she was getting pretty ill while on dialysis, Montgomery said. Doctors were thrilled when they found that Tower had a tissue type that matched Stahl's type almost perfectly.

Nearly Extinguished Hope Is Restored

At that point, Stahl had nearly given up hope on a transplant, and was burned out mentally and physically on the dialysis.

But, via the Internet, her sister and brother found out about the organ swapping and the program at Johns Hopkins.

Allum and her fiancé were the next to seek a transplant, but their blood types were incompatible. Allum had been ill, on dialysis for three years, and had nearly died more than once.

Tower and Weiser-Warschoff were being treated in Washington, D.C. The boy received his first kidney transplant when he was just 17 months old, and it had lasted 12 years, but it was failing.

Weiser-Warschoff's mother, Ellen Weiser, says her son seems to be doing well since the transplant. "His kidneys are working beautifully thanks to the gift which allowedPaul's kidney to be in Jeremy. We're hoping to get many, many, many years with this transplant," Weiser said.

The three procedures were done in 11 hours, with all six operations performed simultaneously, in order to reduce the amount of time that the organ is outside the body. There were two surgeons, and two anesthesiologists involved, as well as operation room nurses, rushing from room to room.

All six patients are doing great, and all have gone home except Allum and Weiser-Warschoff, who will probably leave in a few days.

A live donor kidney lasts 18 to 20 years vs. a cadaver kidney which lasts 8 to 10 years.