13 Recipients Receive the Ultimate Holiday Gift
(Washington, DC) Thirteen people with serious kidney disease received life-saving kidney transplants over a six-day period in December in the world's largest ever kidney exchange. Donors and recipients include people from six states, three police officers, a bank president, a former official with the National Kidney Foundation, three altruistic donors, one of whom is a grandmother, and one who donated because she felt inspired by President Obama's inauguration speech. Many of the recipients came to the exchange with a friend or family member willing to donate, but who were incompatible due to mismatched blood types or because the recipient in need had high levels of antibodies to their donors.
"Those people literally needed a needle in a haystack," said Keith Melancon, MD, director of the Kidney Pancreas Transplant program at Georgetown University Hospital. "Minorities in particular, would find it extremely difficult to find a suitable donor using traditional donor match methods. By putting them in an exchange and giving them the option of a relatively new use of a blood cleansing technique called plasmapheresis, we can greatly increase their chances of getting a suitable donor as well as reduce their waiting time to get a transplant. Why wait in the long line for a deceased donor to come along if you can bring a donor and wait in the short line?"
Ten of the 13 recipients are African American, Hispanic or Asian American, among the hardest racial groups to match with donors.
"These recipients are patients who have been languishing on the waiting lists, some for several years, because of the large number of incompatibilities that makes finding compatible donors for them very difficult," said Jimmy Light, MD, director of Transplantation Services at Washington Hospital Center. "The sophisticated testing by the HLA lab is key to finding both compatible donors and donors with lesser incompatibilities that can be managed by plasmapheresis and immunosuppression to engineer these modern miracles."
Aside from the well-being and quality of life restored to the recipients in the exchange, public and private health insurers stand to save millions of dollars in medical costs. "The cost of dialysis can range from $70,000 to $80,000 a year," said Dr. Melancon. "A kidney transplant can range anywhere from $100,000 to $250,000, including the first year of follow-up care. Even if you count the annual cost of anti-rejection medications, the break-even point for a transplant comes between two and three years," adds Melancon. "Beyond the break-even point, when you consider the difference of about $53,000 between the annual cost of dialysis and anti-rejection medications, the expected life- span of a transplanted kidney, and the 13 adults we transplanted, we're talking about a total savings of as much as $9.6 million over the projected life of the transplant, which is about 15 years. That doesn't even count the savings that occur when these individuals are well enough to return to work and can stop collecting disability payments."
The exchange was kicked off on December 2 with an anonymous altruistic donor from Maryland who said she came forward after being inspired by what she called President Obama's "call to service" in his inauguration speech. The surgeries continued December 4, 7, 8, 9, and 11. On some days the organs crossed town from one hospital to the other. The patients involved in this history-making kidney exchange gathered to meet, some for the first time, at Georgetown on December 15, 2009.
The exchange was kicked off on the first day when an anonymous altruistic donor gave a kidney to Robert Horton of Calverton, Maryland. Next, altruistic donor Sylvia Glaser of Gaithersburg, Maryland, a grandmother, donated to Gertrude Ding of Washington, DC. On the second day, Kelvina Hudgens, who donated on behalf of her mother Meta Hudgens, donated to Irene Otten of Missouri and Irene's husband Tom Otten donated to Roxanne Boyd Williams of Washington, DC. On the third day, Roxanne's father Lucien Boyd from Coconut Creek, Florida donated to Cathleen Robbs of Takoma Park, Maryland. Her husband Steve Robbs, donated to Stuart Bloch of Washington, DC.
On the fourth day, Pamela Hull of Indiana on behalf of her cousin Christopher Conte donated to Meta Hudgens of Washington, DC. Alonda LeCounte of Upper Marlboro, Maryland on behalf of her father Cecil Jerome Deas, donated her kidney to Christopher Conte. On day five, an anonymous donor on behalf of Solomon Weldeghebriel donated to Cecil Jerome Deas. Bill Singleton, a former board member with the National Kidney Foundation and an altruistic donor, donated to Solomon Weldeghebriel. On the last day, Leslie Wolfe, on behalf of her friend Stuart Bloch donated to Renee Patterson of Upper Marlboro, Maryland. Michael Williams who donated on Renee's behalf donated to Jose Cruz of Sterling, Virginia. Diana Garrison of Sykesville, Maryland on behalf of Robert Horton donated to Liping Gao of Herndon, Virginia.
"Each of these transplant exchanges would not occur without 'Altruistic Donors' who are the true heroes in the entire effort," said Dr. Light. All of these donors have shown incredible selflessness. They're so motivated to help their loved ones, and have so much faith and trust in us, they will give their kidney to someone they have never met."
"There are 6,000 people on dialysis in the DC area on a given day. We do about 200-250 kidney transplants a year at all hospitals in this city. Using plasmapheresis and exchanges like this, we hope to double that number of kidney transplants," said Dr. Melancon. Dr. Melancon was on the team that pioneered the use of plasmapheresis to address kidney donor compatibility and is the first to use it to address the racial disparities issue. He began using plasmapheresis with smaller exchanges in January 2009 at Georgetown.
Of the roughly 82,000 people on the waiting list for a kidney in the United States 39% are African American. Yet African Americans only receive about 15% of the living donor organs available. Sixty-one percent of those waiting for a kidney are non-whites, according to the US Department of Health and Human Services.
"Given the prevalence of risk factors for kidney disease in the African American community and some of the other minority populations, it is extremely difficult for someone in need to find a donor who is a close enough match who is willing and medically able to withstand the donor surgery. If they can come to us with one willing donor, we can use plasmapheresis and an exchange like this to match them with someone else who is a closer match," said Dr. Melancon.
Dr. Light said, "This also shows the extraordinary cooperation between the programs at Georgetown and Washington Hospital Center; the transplant coordinators, the operating rooms, the blood banks, the labs all to bring about this complicated, but life-saving chain of events."
Media Contact: Marianne Worley
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