Johns Hopkins experts have successfully completed the first 16-patient, multicenter "domino donor" kidney transplant.
Surgical teams at The Johns Hopkins Hospital carried out the eight-way, multihospital, domino kidney transplant in collaboration with colleagues at Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Medical Center in Oklahoma City and Henry Ford Hospital in Detroit.
The 16 surgeries were performed on four different dates, June 15, June 16, June 22 and July 6.
They involved eight donors - 3 men and 5 women along with eight organ recipients - 3 men and 5 women.
"All Johns Hopkins patients are in good condition and are recovering as anticipated," according to Dr. Robert A. Montgomery, the director of the Johns Hopkins Comprehensive Transplant Center.
The procedure, kidney paired donation (KPD), takes a group of incompatible donor-recipient pairs, and matches them with other pairs in a similar predicament.
By exchanging kidneys between the pairs, it is possible to give each recipient a compatible kidney.
This way, each recipient receives a kidney from a stranger, and transplants are enabled that otherwise would not have taken place.
The experts involved in the transplant say that involving multiple hospitals created even more possibilities for matches, but it also made the procedure more complex.
"We performed a similar six-way domino procedure involving three hospitals earlier this year. We managed to perform all those surgeries on the same day. However, adding two more recipients, two more donors and another hospital meant that we needed a multi-hospital team of eight anesthesiologists, 16 nurses and nine surgeons. The logistics being that much more complicated, we decided it was best to spread the surgeries over several days, the first on June 15 and the last, July 6," says Montgomery.
What makes the new model interesting is the fact that apart from sheer logistics, performing large numbers of transplants on one day puts a lot of strain on the doctors, nurses and staff at each hospital, and also ties up too many operating rooms.
Montgomery believes that it will serve as a blueprint for a national KPD program in which kidneys will be transported around the country, resulting in an estimated 1,500 additional transplants each year.