Strangers Donate Kidneys to Keep Country's Longest Donor Chain Going

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It’s Sunday afternoon, and Dr. Jayme Locke, director of the Incompatible Kidney Transplant Program at the University of Alabama at Birmingham Medical Center, is preparing for a marathon.

“We are going to be doing 14 operations this week,” she said, checking in on her patients.

Sprinkled among the rooms up on the eighth floor are patients waiting to receive the gift of life -- a new kidney. Also among the patients are the living donors bearing those gifts, people who are willingly giving up one of their two kidneys to help a stranger.

“We are anxious, all of us are, to hear the story of our recipient,” said Pastor Derek Lambert, one of the donors. “I don’t know if this is perhaps a young mother who’s feared leaving her kids, or a young man who is unable to provide for the needs of his family and this would give these types of individuals a new lease on life.”

They are all part of an intricate living donor kidney transplant chain that began last December. By the end of the week, 21 patients will have received kidney transplants making it the longest, on-going, single-institution chain in the country. The catch? In order to receive a kidney from a stranger, each recipient must have someone in their life willing to donate a kidney to a stranger in their honor to keep the chain going.

For donor Courtney McLaughlin, the decision to donate in her cousin’s honor was easy. “She’s been on a waiting list for a deceased donor for years and with no end in sight, and we’ve been on this list for three months and here we are,” she said.

More than 100,000 Americans are currently in need of a kidney transplant. For some, the wait for a kidney from a deceased donor can stretch as long as eight to 10 years. These living donor kidney chains can expand the pool of both donors and recipients and have the possibility of shortening wait times to just months. They also can provide recipients with more compatible matches and younger organs.

A year ago, Katelyn Pickel, an 18-year-old high school student, suddenly became severely ill, wound up on dialysis and required a kidney transplant. Her father Earl was a potential match for her, but by the two of them joining the chain, two things happened: Katelyn received a kidney from a much younger donor, and someone else waiting on the list was able to receive her father’s kidney.

“I have prayed to God that he would send an answer to my child. And He has,” Earl Pickel said. “How can I refuse someone else when somebody stepped up for me?”

Mickey Little had suffered from a rare kidney disease for more than a decade and he had become dependent on dialysis that kept him tied up to a machine for 8 hours every night. A previous transplant that failed after just a few days had left him with a less than one percent chance of finding a match. It took a while, but Dr. Locke was able to find him not only a match, but a perfect one.

“I won’t be restricted because of dialysis,” Little said. “I should be back to a normal life again which is amazing to me.’

“[He] certainly beat the odds,” said Dr. Locke. “He found his one in a million.”

Click on the infographic below explaining UAB's kidney donation chain to see a larger version. Story continues on Page 2 after the jump.

Actually, Dr. Locke and her lead operating room nurse Katie Stegner found Mickey Little’s match. It is a painstaking process full of false starts and broken hopes as Stegner pores over patient files hoping to find matches to continue the chain and change people’s lives. When her computer can’t make the match, she does it by hand.

“I have tons of paper with different options,” Stegner said. “[I] kind of put it together like a mathematical equation.”

When she and Dr. Locke think they have a possible match, they confirm it in the lab, comparing tissue and blood samples.

The white boards lining her office are filled with dozens of permutations of possible matches. “There are so many patients on the list that come in just begging to be a part of it,” Stegner said, turning away to hide tears.

Stegner may have seen it all in the 14 years she has worked in the OR, but diving into these patients’ charts, working to make matches by hand has softened her heart.

“At my old job... I was involved solely in the OR and they were just abdomens," she said. "Now they are really people. They really are.”

This current chain is unusual because it all started with what is called an “altruistic” donor. Paula Kok, who started the chain, simply wanted to donate a kidney to a stranger. She had no one in her life who needed one in return.

“It was as if the Holy Spirit of God was just saying to me, you are somebody’s stranger. I have put in you the means to let somebody else enjoy the rest of their life,” Kok said.

“I think what Mrs. Kok did is truly profound,” Dr. Locke said. “She came forward and what she did was she literally set off the equivalent of a domino. This chain can go until we decide to stop it.”

Potential donors face the risks associated with any major surgery, but they are evaluated by the team at UAB to ensure that they can go on to lead a totally normal life with just one kidney.

For Dr. Locke, these chains could potentially be game changers, especially if they could be created through a national system.

“I think it’s really going to require us to come together as a country and create one national system. Right now there are a lot of private entities that are doing it,” she said. “But if we could that then I really think we would be able to optimize living kidney donation in this country in a way that we have never been able to do before. And I think we could actually begin to make a significant dent in our waiting list.”

During the course of a week, Dr. Locke personally sewed four kidneys into their new homes. What goes through her mind when the kidney transplant starts to work right there on the operating table?

“How fortunate I am to have just witnessed another miracle, because to me that’s what these are, to the patients that what this is," she said. "You look into people’s eyes and you see hope that wasn't there before. You see the promise of a future they weren't sure they were going to have. This is life-changing and life-saving and you see that. …It is so humbling to be able to be a part of this and be able to help people really realize the gift of life.”

Starting in early July, the chain will continue once again at the University of Alabama at Birmingham Medical Center. They hope to complete 50 transplants by the end of the year.

Read more about the UAB kidney chain, including stories from many of those involved, at www.uab.edu/kidneychain. To become a living kidney donor, visit uabmedicine.org/kidneytransplant, or to indicate your interest in donating your organs after death, visit www.organdonor.gov.