Domino Surgery Transplants Kidneys in 13 Patients
Just like a story from “Grey’s Anatomy”, doctors at Georgetown University Hospital and Washington Hospital Center performed twenty-six operations over six days to transplant kidneys into thirteen desperately ill patients. The domino surgery set a record for the largest organ exchange of its kind.
Many of the donors did not know the recipients of their donated organs, but participated because a loved one needed surgery. Tom Otten, a suburban St Louis police officer, traveled to Washington DC to give a kidney to a stranger because he was not a match for his wife. She, in turn, received a kidney from someone else during the marathon operation.
The surgery is known as “paired donation kidney surgery” or “domino surgery”, as surgeries are dependent upon the one that occurred before theirs like falling dominoes. According to the Alliance for Paired Donation, many people who need kidney transplants have family or friends who are willing donors, but blood and tissue are not compatible
The paired donation system widens the pool of potential organs because incompatible pairs of donor and recipients are mixed and matched. According to the National Kidney Foundation, paired donation will one day allow for an additional 3,000 living donor kidney transplants a year in the United States.
Dr. J. Keith Melancon, the kidney transplant director at Georgetown, and his team of transplant coordinators and lab scientists met each Wednesday afternoon for months to coordinate the surgeries. A magnet board was used to hold names and vital statistics of potential donors on green cards and recipients on red ones.
Dr. Melancon was part of the team of doctors at Johns Hopkins Hospital in Baltimore who conducted the first six-person kidney swap in April 2008. He first became interested in transplant surgery during his residency at Tulane University in New Orleans.
Ten of the 13 recipients were black, Asian, or Hispanic - important because minorities are less likely to get kidney transplants from a living donor. Of the 88,000 people on the national waiting list for a kidney, just over one-third are black, yet they only receive about 13% of living-donor kidneys. Overall, fewer than 17,000 kidney transplants are performed each year.
Each surgery was performed laparoscopically through two 4-inch incisions in the abdomen. It takes about a half an hour longer to extract a man’s kidney than a woman’s because the tissue encasing is thicker and more fibrous. And the kidney is about the size of one’s fist, so size can be an issue.
A domino surgery was performed on season 5 of Grey’s Anatomy, in which Dr. Miranda Bailey coordinated 12 kidney transplants in six O.R.’s at the same time.