If you are currently on the kidney transplant list, you may have heard of paired kidney donation. When a family member or friend who is willing to be a living donor, but is not compatible to their intended recipient they can choose to be part of a paired kidney exchange. The transplant team will work to match another donor and recipient to create a donation “chain.” Frequently you’ll see “chains” in the news with, 9, 14, or even 32 donors and recipients paired together for kidney donations.
Recently, the University of Maryland School of Medicine in conjunction with the National Kidney Registry participated in a 28-person paired kidney exchange. One of these patients with polycystic kidney disease (PKD) was able to avoid dialysis entirely because of this exchange. PKD is a genetic disorder which can enlarge kidneys to the size of footballs, primarily due to the presence of fluid filled cysts, which impedes the ability of kidneys to clear toxins and fluids from the body.
The University of Maryland Medical Center (UMMC) is one of only a few centers in the U.S. that treat PKD by removing both kidneys and replacing them with a living donor kidney in one operation. Wayne Hubbard was diagnosed with PKD in his 20’s but only recently did his enlarged kidneys begin to impede his breathing and ability to complete daily tasks. While dialysis would have helped filter the toxins from his body, because of the severity of his PKD the other ailments produced by his enlarged kidneys would not be solved by dialysis alone.
University of Maryland surgeons developed a detailed plan for this procedure to minimize any risks. The surgical team was prepared to initiate immediate dialysis on Wayne if the donor kidney was not ready in time in addition to having a back-up recipient available in case the PKD procedure could not be completed. The procedure was almost seamless. “Just as the new kidney arrived in our operating room, we wrapped up our removal procedure, and other members of our transplant team began working in that same OR to transplant the donor kidney,” says David B. Leeser, MD, chief of kidney and pancreas transplant at UMMC.
The hereditary nature of PKD makes it difficult for PKD patients to find suitable donors among family members who may have PKD themselves. Finding a willing living kidney donor outside of blood relatives and utilizing the paired kidney exchange option may widen the options for PKD patients to find compatible donors.
