Finding a Perfect Match: A Look Into How the Kidney Exchange Process Works

[Karol]

Finding a Perfect Match: A Look Into How the Kidney Exchange Process Works

Posted: Friday, August 2, 2013 3:20 pm | Updated: 10:36 am, Sat Aug 3, 2013.
By Madelyn Pennino | 1 comment

Last month, BCTV.org brought you the first part of a two part series about kidney donation and how two childhood friends were brought back together through illness.
In part two, BCTV.org explores the kidney donation process itself and how the relatively new trend of “kidney swapping” works.
Becoming a kidney donor can be a complicated process with lots of twists and turns.
Potential donors not only need physical and psychological endurance in order to undergo months of medical testing, it also requires a unique kind of patience and resolve.
It’s much more than a matter of getting from point A to point B – it’s a journey.
One such journey has recently ended for 28 kidney donors and 28 recipients from across the country – with two participants’ from right here in Berks County – in the second largest kidney exchange in history.
In June, the Hospital of the University of Pennsylvania and the National Kidney Registry in partnership with 18 transplant centers across the U.S. completed the second largest kidney exchange in history and the largest to be completed in less than 40 days.
Donna Collins, Penn transplant coordinator, who was instrumental in the swap called “Chain 221” quite a feat.
“Chain 221 is pretty significant,” Collins said. “It (a chain) never happened this quickly before.”
The largest kidney swap in history took place in 2012.  It included 60 donors and recipients and took six months to complete.
Doctors agree how swiftly the exchange came together is remarkable considering it can take years for an individual on a transplant list to receive a kidney. 
Dr. Peter Abt, a transplant surgeon at Penn, said the waiting list for a kidney at the hospital can be as long as four or five years.
“It’s a matter of supply and demand,” Abt said. “It also depends on what region of the country you live in.”
It also greatly depends on whether a recipient and donor are a blood type and tissue match, which is necessary for a transplant to occur.
In many cases, potential donors for an intended recipient aren’t a match, making waiting for a transplant even longer.
That could have happened to recipient Jerry Rozycki.
However, due to the popular trend in transplant medicine called kidney swapping Rozycki and many others are receiving kidneys more quickly than ever before.
Here’s how a kidney exchange works:
When a donor and recipient aren’t compatible, the pair is put into a nationwide kidney transplant computer database that consists of hundreds of other non-matching donors and recipients.
Then through an elaborate computer algorithm, matches are made.
In the case of “Chain 221,” the initial donor was a man named Steve Mulroy, a University of Memphis law professor.
From there, the chain, involving a family member or friend, found its way to 28 patients awaiting life-saving kidney transplants across the country, including David Goldman, of Buffalo Grove, Illinois, who received John Furdyna’s kidney.
Goldman received Furdyna’s kidney at the University of Wisconsin Hospital on May 30th, the same day Furdyna had surgery at Penn.
A lifelong diabetic, the disease had harmed Goldman’s kidneys, which resulted in his sister donating a kidney to him more than 25 years ago.
Several years later Goldman’s diabetes became unmanageable and he had a pancreas transplant to cure him of the disease.
In Dec. 2010 doctors told Goldman that the kidney his sister had donated was failing and he was put on a transplant list.
Initially a friend wanted to donate a kidney to Goldman, but turned out to be incompatible.
However, when word of Goldman’s ordeal spread a stranger by the name of Patty Barth tried to become a donor.
But she wasn’t a match for Goldman either.
Barth didn’t quit though.
In late April Barth suggested she and Goldman join a kidney chain.
So they did.
One week after being “activated” in the chain, doctors at the University of Wisconsin told Goldman he had 80 matches with Furdyna being the best kidney match.
Now more than two months after the operation, Goldman said he feels great.
“When I woke up in recovery I immediately felt different,” Goldman said. “I had a strength I hadn’t felt for 2 ½ years.”
As part of the exchange, Barth’s kidney went to a recipient in Cincinnati.
While everyone in “Chain 221” is recovering well, kidney donation is not as simple as signing a piece of paper and having surgery.
It’s a commitment that requires just as much mental stamina as it does physical.
Potential donors must undergo multiple tests to make sure they are medically suitable for surgery.
Recipients also are evaluated to determine whether they are mentally well enough to have surgery and tolerate anti-rejection drugs.
Dr. Paige Porrett, Rozycki’s surgeon at Penn, said a transplant was crucial in Rozycki’s case.
“If he had not had a transplant Jerry would have needed dialysis to stay alive,” Porrett said.
She said Rozycki’s surgery was uncomplicated.
“He got a great kidney,” Porrett said.
Rozycki, who also received a kidney on May 30, does not know who his kidney donor is.
Dr. Matthew Levine, Furdyna’s surgeon, said that his surgery was also unproblematic.
“He had no medical reasons why he couldn’t donate,” Levine said.
“This particular operation was very straightforward without intraoperative issues.”
Most kidney donors recover in 6 to 8 weeks and the overall survival rate for a recipient is 99 percent.
Porrett said those who receive a transplant can look forward to many healthy years.
“Most patients will live longer if they get a transplant and get off dialysis,” Porrett said.
Thanks to unselfish donors like Furdyna.
Collins said donors are a very special group of people.
“They don’t get any medical or monetary gain from this,” Collins said. “They are VIP patients and put others ahead of themselves. They are true heroes.”
Goldman agreed.
“Being a part of the transplant community for a long time I have met so many people that are alive because of organ donation,” Goldman said.
Goldman talks about it in a recent YouTube video.
While recipients have the gift of good health after surgery, donors also feel they have been given a gift too.
 “Realizing that I’m part of such an exchange as ‘Chain 221,’ where so many things had to fall into place is incredible. I am very grateful that I was healthy enough to participate, and the feeling of knowing that two other lives were enhanced by my donating is indescribable,” Furdyna said. “It’s been a fantastic experience.”

http://www.bctv.org/special_reports/health/finding-a-perfect-match-a-look-into-how-the-kidney/article_9df4fc06-fba8-11e2-b778-001a4bcf887a.html