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5-way kidney swap performed at Hopkins

November 21, 2006 06:03:55 PM PST

It took 12 surgeons, six operating rooms and five donors to pull it off, but five desperate strangers simultaneously received new organs in what hospital officials Monday described as the first-ever quintuple kidney transplant.

All five recipients — three men and two women — were doing fine, as were the five organ donors, all women, said Eric Vohr, a spokesman at the Johns Hopkins Comprehensive Transplant Center. The 10 participants came from Canada, Maine, Maryland, West Virginia, Florida and California.

Several triple transplants have been done at Johns Hopkins, but hospital officials said the five simultaneous transplants performed last Tuesday were a first.

Four of the sick patients had approached Johns Hopkins with a relative who was willing to donate a kidney but was an incompatible donor. The fifth patient had been on a waiting list for a kidney from a dead person.

Together, those nine people and an "altruistic donor" — someone willing to give a kidney to anyone who needed it — had enough matched kidneys among them to pull off a complex, five-way swap.

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Once the swap was agreed to, the transplants were done all at the same time to prevent anyone from backing out later or in case someone fell ill.

Dr. Robert Montgomery, director of Hopkins' transplant center and head of the transplant team, pronounced the interlocking deal "a demonstration to the rest of the country that this is what's possible when people work together."

Sheila Thornton, 63, of Edgewood, said she felt "just joy, joy, it's almost inexplicable," after she learned she would receive a kidney from Sandra Loevner, 63, of Sarasota, Fla., whom she had never met.

"That really hit home," Thornton said of receiving a lifesaving gift from a stranger. "How do you thank somebody?"

The altruistic donor, Honore Rothstein of Martinsburg, W.Va., decided to donate a kidney after losing her husband to a brain hemorrhage and her daughter to an overdose. She did not know any of the donors or recipients.

"I'm thrilled I'm giving to somebody," Rothstein said, sitting next to Kristine Jantzi, 40, of Bangor, Maine, who received her kidney. "Her mom couldn't give to her, and I couldn't save my daughter."

The operations involved six operating rooms, 12 surgeons, 11 anesthesiologists, and 18 nurses, and took place over 10 hours. The removal of the donor organs began at 7:15 a.m. and was completed by 11 a.m. The kidneys were implanted in operations that began at 1 p.m. and were finished at 5:15 p.m.

Last year, Johns Hopkins doctors performed a triple transplant also involving an altruistic donor. The donor was from a Christian group, many of whose members have given kidneys to strangers.

Annie Moore, a spokeswoman for the United Network for Organ Sharing, the nonprofit organization that coordinates U.S. organ transplants, said she wasn't aware of any other quintuple kidney transplants. Triple transplants are the biggest that have been performed up to now, and paired transplants are more common, Moore said.

Most kidney transplants use organs taken from cadavers, but doctors prefer organs from live donors because the success rates are higher.

In a live-donor practice used increasingly in the U.S. over the past few years, a patient who needs a kidney is matched up with a compatible stranger if the patient lines up a friend or relative willing to donate an organ to a stranger, too.

About 16,500 kidney transplants were performed in the United States in 2005, of which about 10,000 involved organs taken from dead people and 6,500 from living donors, according to the Organ Procurement and Transportation Network.

About 70,000 people are waiting for a kidney transplant in the United States. The wait averages about five years, during which time 30,000 will either die or become too sick for a transplant, Montgomery said.

Montgomery called for a national kidney-swap program, saying it could help ease the shortage of transplant organs and cut costs by getting people off dialysis. He said 6,000 people on the waiting list for a kidney from a dead person have a willing but incompatible donor.

He noted, however, that live-donor kidney swaps present ethical problems for some institutions since federal law prohibits receiving something of value in exchange for an organ. Some institutions feel multiple arrangements come uncomfortably close to quid pro quo, Montgomery said. He called for a clarification of the law.

The complicated swap worked this way:

Rothstein donated her kidney to Jantzi. Jantzi was incompatible with the kidney offered by her adoptive mother, Florence Jantzi, a Christian missionary who donated her kidney to George Brooks, 52, a mechanic who was not compatible with the kidney offered by his wife, Sharon Brooks.

Sharon Brooks, 55, a telephone company maintenance administrator, donated her kidney to Gary Persell, 61, a retired film distributor. His wife, Leslie, 61, a retired history teacher, gave her kidney to Gerald Loevner, 77, a real estate developer. Loevner's wife, Sandra, gave a kidney to Sheila Thornton, a retired elementary school teacher.

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Johns Hopkins Medicine: http://www.hopkinsmedicine.org