ALTRUISTIC DONOR MAKES POSSIBLE THE FIRST “DOMINO” THREE-WAY KIDNEY TRANSPLANT OPERATION

Johns Hopkins Medicine
Office of Corporate Communications
MEDIA CONTACT:  Trent Stockton
PHONE:  410-955-8665
E-MAIL:  [email protected]
May 19, 2005
 

THREE-WAY "DOMINO" KIDNEY TRANSPLANT INCLUDES A FIRST

Surgeons at The Johns Hopkins Comprehensive Transplant Center on May 15, 2005, performed what

Transplant Coordinator, Janet Hiller, R.N.  Recipient, Scott Keller with wife and donor Lisa Keller

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 where none would have been possible and all three recipients received the most compatible kidney from someone they had never met.  All three transplanted kidneys are working well and the six donors and recipients are recovering quickly,” added Montgomery.

The other five patients included two incompatible donor-recipient pairs and a patient on the deceased donor wait list.  Harmful antibodies due to blood-type or tissue-type mismatches would normally make it impossible for members of either pair (one a father-daughter and the other a husband-wife) to give a kidney to their loved one, but using a new method developed by Johns Hopkins scientists that combines kidney exchange with a blood-filtering technique that removes harmful antibodies that cause incompatibilities, called plasmapheresis, the Hopkins team was able to perform all three transplants.

“Adding plasmapheresis to the mix means that the matches do not have to be perfect, and many more people can be transplanted,” said Montgomery.  “But the biggest reason any of these patients were able to get the kidneys they desperately needed was the generosity of our altruistic donor whose gift produced a domino effect.”

 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.  To date, Hopkins surgeons have performed eleven paired kidney exchange transplants.  On Feb. 29, 2004, Hopkins performed a second successful triple kidney exchange.

 The May 15, 2005, recipients are Scott Keller, 30, of Kalamazoo, MI; Robert O’Hara, 64, of Vestal, NY; and Ashley Day, 40, of Altoona, PA.  The donors are Barry Mendez, 30, of Sydney, Australia; Lisa Keller (wife of recipient Scott Keller), 31, of Kalamazoo, MI; and Kelley O’Hara (daughter of recipient Robert O’Hara), 40, of Falls Church, VA.

 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 about Johns Hopkins' incompatible kidney transplant programs, call toll-free 888-304-5069 or 410-614-6074, or visit the Web site at http://www.incompatiblekidneys.org .

 The other surgeons in the case were Matthew Cooper, M.D.; Thomas Jarrett, M.D.; Joseph Melancon, M.D.; Warren Maley, M.D.; Louis Kavoussi, M.D., Dorry Segev, M.D., and Tomasz Kozlowski, M.D.

Related Web site:

The Johns Hopkins Comprehensive Transplant Center
http://www.hopkinsmedicine.org/transplant/

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