http://articles.philly.com/2011-08-16/news/29892691_1_deceased-donors-kidney-life-donor-programLocal kidney-donation chain links mismatched pairs
By Helen H. Shen
When Anne Peniazek decided to donate a kidney at age 65, the Narberth woman had bigger hopes than helping just one person. She and her surgeon James Lim of Lankenau Medical Center wanted to start a movement.
Instead of arranging a typical kidney donation, Lim helped her start an open-ended kidney-donation chain, one of a small number in the United States.
In December, Peniazek's kidney was given to Geoff Bowman of Philadelphia, who at age 32 had already had three transplants. In turn, Bowman's Bible-study friend Sharon Haines donated a kidney to Craig Shofed, 46, from Trenton. The chain continued when Shofed's wife then donated a kidney to James Crowder of Pottstown, who had been on dialysis for more than a year.
The chain has so far benefited five local kidney patients. It also marks the first time that 15 transplant centers in the region collaborated so closely. The partnership continues: A sixth donor kidney is potentially awaiting a matched recipient who can step up with a donor.
The idea of a kidney-donation chain may seem complicated, but simpler schemes are not meeting the demand. Today, more than 89,000 people in the United States are waiting for kidneys from the usual source - deceased donors - and more than 4,000 last year died waiting.
More than 5,000 patients are waiting in the Philadelphia region alone, far more than the 767 individual kidney transplants coordinated last year by the Gift of Life Donor Program, the region's federally designated organ-procurement group.
That is where donation chains can make a difference. Transplants work only between people with matching blood types and compatible immune systems. Some patients are harder to match than others and can end up waiting indefinitely.
A chain grows from pairs of people, often spouses or relatives. One needs a kidney. The other is willing to give a kidney, but is not a match. In the past, that would have been the end of the line.
Now, this donor may be considered as a potential match for the patient of a different mismatched pair.
If an outside kidney can be found for his or her original partner, the first donor "pays it forward" by donating a kidney to another stranded pair. The chain continues as long as each donor is still willing to give. The agreement is voluntary.
"It's not a payment situation," which would be illegal, notes bioethicist Arthur Caplan of the University of Pennsylvania. "It's more like a payment in kind."
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