Transplant Nephrology

Three-Way "Domino" Kidney Transplant Includes a First

Surgeons at Johns Hopkins performed what is believed to be the world's first "domino" three-way kidney transplant involving an altruistic, non-directed living donor. Prior to the surgeries, transplant specialists searched their wait list of recipients for the best possible "matches" for kidney donors and discovered that a domino-effect could be achieved by including an altruistic donor who was willing to give his kidney to anyone who needed it.

"The shortage of donor kidneys for patients who need kidney transplantation is a national public health problem," says Robert A. Montgomery, M.D., Ph.D., lead surgeon on the case and director of Comprehensive Transplant Center at Johns Hopkins. "In this case, an altruistic donor's gift allowed three transplants to take place. All three transplanted kidneys are working well and the six donors and recipients are recovering quickly," added Montgomery.

The Hopkins team performed its first "triple swap" kidney exchange on July 28, 2003, building on the success of the paired kidney exchange program that it began in 2001. In a paired kidney exchange, incompatible donors agree to give a kidney to a stranger in order for their loved one to receive a kidney.

More than 60,000 people await kidney donation and are listed on the United Network of Organ Sharing (UNOS) recipient registry, and nearly one-third of patients with willing donors are excluded from kidney transplantation because of blood-type and other incompatibilities.

For more information visit the Johns Hopkins website for Incompatible Kidney Transplant Programs