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Peggy Scavo of York, Maine, knew she would donate a kidney to husband John when the time came. “It wasn’t a surprise when we found out he needed a transplant,” Scavo said of her husband, who had received treatments for kidney disease his whole life.
A year and a half ago, it was time for a transplant. When Peggy Scavo and 12 other friends and family members didn’t match John’s blood type, doctors prepared him to begin dialysis and be placed on the waiting list for a kidney from a deceased donor.
Enter the New England Paired Kidney Exchange (NEPKE). The program, which is facilitated by the New England Organ Bank, last year began finding cases where the donor in an incompatible pair—like the Scavos—can be matched to a recipient in another pair. By exchanging donors, the program may find a compatible match for both recipients—a win-win situation all around.
“The very best option for patients with end-stage renal disease is to get a kidney from a live donor,” said Stefan Tullius, MD, PhD, BWH’s division chief of Transplant Surgery. “Patients do not have to wait for what could be years on the deceased donor transplant waiting list.”
Before John Scavo ever began dialysis, the Scavos learned they had a match through the program. Weymouth resident Ken Rice was a patient at BWH who had been on dialysis for 13 months for end-stage renal disease. Rice’s close friend, Melissa Costa of Florida, offered to donate a kidney to him, but their blood types were incompatible. A caregiver at BWH had suggested they enroll in the NEPKE program to increase their chances of finding a match.
“Within just a few days of calling NEPKE, I got a call from Kristen Pelletier (BWH Renal Division transplant coordinator), and boy, it just seemed to take off from there,” John Scavo recalled.
With both parties willing to do the exchange, three doctors in June performed the surgeries over a 10-hour period. Sanjaya Kumar, MD, and Jim Hu, MD, MPH, performed the donor surgeries, and then Tullius conducted both transplants. A team of nurses, anesthesiologists, technologists and others were crucial to the success of the kidney exchange, the first of its kind at BWH.
All four are doing well today. “I have so much more energy now,” John Scavo said. “Food tastes better and my diet is less restricted than it’s ever been.”
Kidney donors, in general, are back to normal activity within a few weeks. Their decision to donate makes a world of difference to the recipient, who enjoys a greater quality of life after the transplant. A kidney transplant usually doubles the recipients’ life expectancy and dramatically reduces the risk for additional diseases while staying on dialysis.
“Donors are very special people,” said Paul Faircloth, LICSW, social worker at BWH who works with transplant recipients. “It’s a life-changing experience for the patient. Usually, the decision to donate has to do with the relationship between the donor and recipient, but sometimes it’s completely altruistic, with a person donating to someone they don’t know on the transplant list.”
Options like NEPKE’s exchange program are available for donors who do not match their loved one. Another option is for a donor who is incompatible with a recipient to donate to the deceased donor transplant list. That ensures that the recipient with whom the donor was not compatible takes the first spot on the waiting list, so the donor’s decision helps a loved one and another person benefit.
“All of these options can be facilitated by BWH and the New England Organ Bank,” Tullius said. “It’s important for potential donors to know that just because they don’t match their intended recipient, there are other ways to help that person receive a kidney.”
For more information, visit www.brighamandwomens.org/transplant surgery
Clinical staff interested in learning more about the organ donation process should e-mail Shaun Golden at firstname.lastname@example.org to learn how they can get involved in this special program at BWH, the birthplace of organ transplantation.
In addition, the New England Organ Bank will sponsor a Regional Local Learning Session on Nov. 15 at the DoubleTree Hotel in Westborough. For more information, e-mail email@example.com
BWH last week received the U.S. Department of Health and Human Services’ distinguished Organ Donation Medal of Honor in recognition of the hospital’s outstanding support for and continuing success in organ donation. BWH was honored for consistently achieving adjusted donation rates of 75 percent or higher in a 12-month period.
Shaun Golden, BSN, RN, CNRN, nurse manager of the Neurosciences Intensive Care Unit, accepted the award on behalf of BWH at the Organ Transplantation Breakthrough Collaborative Second National Learning Congress in New Orleans. BWH partnered in the Organ Transplantation Breakthrough Collaborative, a nationwide collaborative sponsored by the Department of Health and Human Services/Health Resources and Service Administration that began in 2003 and wrapped up at the congress.