BWH surgeons performing a kidney transplant.
In 1954, the first organ transplant in the world – a successful kidney transplant – was performed at Brigham and Women’s Hospital. Since then, over 1800 kidney transplants have been performed at BWH, including the first successful transplant between relatives who were not identical twins, and the first successful deceased donor transplant.
In October 2006, BWH received the 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.
BWH’s First Kidney “Exchange” Increases Quality, Length of Life
Peggy Scavo of York, Maine, knew she would donate a kidney to husband John when the time came. But when it was time for a transplant, Peggy Scavo and 12 other friends and family members found they 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.
Peggy and John Scavo
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, had 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 a 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 2006 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.
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.”
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