THIRD SURGERY SCHEDULED FOR WEDNESDAY
Transplant surgeons Dr. Randolph Schaffer, left, and Dr. Jonathan Fisher work to remove a kidney from a living donor as surgical technician Jennifer Pinto, center, and other medical workers assist them at Scripps Green Medical Center in La Jolla on Tuesday. (Photo by Hayne Palmour IV - Staff photographer)
Loading…Four kidney transplant patients ---- two donors and two recipients ---- rested in the intensive care unit Tuesday at Scripps Green Hospital after surgeons and nurses completed the first two-thirds of what is to be San Diego County's inaugural three-way kidney exchange.
The four patients, and two more on Wednesday, are part of a growing trend in transplant medicine that is gradually blurring the traditional lines of donor and recipient nationwide.
In the past, donors have usually been somehow related, either by blood or relationship, with the person who gets their kidney. The problem is, many donors cannot give to their loved ones because of incompatible blood type or antibody matches. But hospitals like Scripps Green are increasingly able to set up multiple-person swaps between strangers that connect donors with recipients who have never met.
The donor pool has been broadened by the simple biological fact that humans come with two kidneys, but need only one to filter their blood, and the recent development of improved anti-rejection drugs and a nationwide computer database that tracks potential donors.
Scripps' first foray into the new world of kidney matchmaking began early Tuesday when doctors Randolph Schaffer and Jonathan Fisher removed the kidney of a young woman and transplanted it into a college student from San Diego whom she has never met. Later that day, Scripps' transplant team, led by Dr. Christopher Marsh, did the same for the first woman's stepfather, who received a kidney from the husband of a woman who is scheduled to receive a kidney from a unrelated third "altruistic" donor on Wednesday.
The arrangement ensures that everyone gets a kidney from a person who is a close match to their blood and antibody profile, even though none are related.
The North County Times was able to observe the second of Tuesday's two transplant operations at the Scripps hospital.
Dr. Schaffer first used laparoscopic probes to precisely expose the donor's kidney, working with a tiny camera and scissors to cut away just enough tissue to remove the organ. He then reached a gloved and thoroughly sterilized hand and arm deep inside and cut and clamped the renal vein and artery, and the ureter tube, before pulling the fist-sized pale pink organ out of the patient's body.
"That's going to be a good-looking kidney," noted Dr. Fisher, minutes before Dr. Schaffer handed him a small metal dish with the organ floating in a water bath.
Fisher's job was to trim excess fat and make sure all of the kidneys' internal functions were normal before passing it to Dr. Marsh. Working with a Naval service resident, Marsh made the surgical sutures necessary to splice the new kidney into the recipient's renal and circulatory systems.
Because the kidneys only had to travel a few short yards from one operating room to the next, doctors said the recipients will have a much lower chance of organ failure.
Watching his colleagues work, Fisher was visibly excited about the prospect of more recipients finding donors through the new computerized matching protocol.
"The prediction is that it will add about 3,000 more kidneys per year to the pool," Fisher said. "That's just exciting."
Because it was the region's first three-way kidney swap, donors and recipients told Scripps that they wanted their identities kept private. Ensuring that privacy fell to Michelle Roberts, the hospital's director of organ transplants.
Besides assigning each patient a Disney character pseudonym, Roberts worked to minimize the chance that the families of each patient would encounter each other. Patients were located as far away from each other as possible within the hospital, but there was only so much that could be done in shared spaces like waiting rooms.
"With six patients all in the hospital at once, I can't ever guarantee that they're not going to see each other," Roberts said.
In the end, families and patients will probably discover each others' identities only if they make an effort.
"We say, 'Don't ask if you don't want to know,'" Roberts said.
Call staff writer Paul Sisson at 760-901-4087.
Posted in Sdcounty on Tuesday, December 15, 2009 10:35 pm Updated: 8:40 am. | Tags: Top, Nct, News, Regional, San Diego,