New kidney transplants in US offer a fresh ray of hope

Washington : Twenty-six operations put healthy kidneys into 13 desperately ill people: Doctors have just performed a record-setting kidney swap, part of a pioneering effort to expand transplants to patients who too often never qualify.

"A whole new doorway of hope opened," says Tom Otten, a suburban St Louis police officer who travelled halfway across the country to Georgetown University Hospital to give a stranger a kidney so his wife would get one in return.

Relative after relative failed to be the match his wife, Irene, needed. Tests finally showed her body wouldn't tolerate a kidney from 95 per cent of the population.

In Washington, Roxanne Boyd Williams was a similar long shot. A sister's kidney had saved her in 2005, but it failed this year. This time around, the 30-year-old mother's immune system also had become abnormally primed to attack any new organ.

Dr Keith Melancon, Georgetown's kidney transplant director, offered a rare option. If both women could receive a close-to-perfect donor kidney — one that few of their immune system's elevated antibodies recognise — he'd filter from their blood enough of the remaining antibodies to allow the new organ to survive.

A kidney exchange widens the pool of potential organs. That's when patients find a friend or relative who isn't compatible with them but will donate on their behalf, and the pairs are mixed and matched.

Tom turned out to be Roxanne's needle in the haystack. Another young woman was Irene's. Roxanne's father came from Florida, the answer for yet another impossible-to-match grandmother.

"It's a large gift to give somebody, something so selfless," Williams says, her hand clutching Otten's as the two meet after surgery. "God bless you."

The chain reaction — multiplied by three altruistic donors, people offering a kidney to anyone — turned into a 13-way transplant, during six marathon days of surgery at Georgetown and nearby Washington Hospital Centre. It's believed to be the largest exchange of its kind in a movement that could reduce the nation's long wait for a donated kidney.

Five patients got kidneys only because of blood-filtering. And strikingly, 10 of the 13 kidney recipients are black, Asian or Hispanic — important because minorities are far less likely than white Americans to get a kidney transplant from a living donor.

"You are going to die a lot earlier sitting on that dialysis machine than if you get transplanted," says Melancon, whose goal is to pair domino kidney exchanges and the blood-cleansing treatment called plasmapheresis to narrow the disparities.

Of the 88,000 people on the US national waiting list for a kidney, just over one-third are black, yet they receive only about 13 per cent of living-donor kidneys. Blacks are disproportionately struck by the kidney-killing twin ravages of diabetes and hypertension, leaving those on dialysis with fewer donor candidates among their own family and friends. Fewer than 17,000 kidney transplants are performed a year. "These procedures really multiply the number of transplants that can be done," Melancon says, predicting the two together could enable up to 4,000 additional transplants a year. "It's really almost a religious experience... because it's miraculous, it really is."