'Momentous feat': 60 patients, 17 hospitals form record transplant chain

Longest-ever chain survives several logistical setbacks

Topics: Outpatient Care, Service Lines, Geriatrics, Surgery

February 22, 2012

The New York Times this week detailed a domino kidney transplant chain that linked 60 patients and 17 hospitals across 11 states, breaking the record for the longest chain ever constructed. 

Building a chain
Domino chains were first attempted in 2005 at Johns Hopkins and aim to connect patients in need of organs with compatible, living donors.

The chains were seen as a more effective way to get transplants to patients who need them. According to the United Network for Organ Sharing, which maintains the waitlist for the U.S. government, about 90,000 people are waiting for a kidney, but fewer than 17,000 will receive one each year and 4,500 will die waiting.

Because of difficulties associated with finding immunological matches, only about one in three transplant kidneys come from living donors, even though research suggests that they typically last longer than those from deceased donors.

Chains and other paired exchanges led to 429 transplants in 2010, and computer models suggest that up to 4,000 transplants could be performed annually, if more U.S. residents knew about matching programs.

The 60-transplant chain was created by Garet Hil, who in 2007 launched the National Kidney Registry after his nephew donated a kidney to save Hil's 10-year-old daughter. The registry uses an algorithm to pair donors and recipients and typically contains 200 to 350 donor-recipient pairs. Currently, 58 of the nation's 236 kidney transplant centers participate in the registry, which helped arrange 175 transplants in 2011.

Thirty kidneys, 60 operations
Over four months, the National Kidney Registry connected 60 people at 17 hospitals across 11 states. The domino chain—which broke the previous chain record by seven transplants—survived several logistical setbacks, including a donor who decided to drop out for unknown personal reasons.

For example, the Times explains how a Good Samaritan donor asked to give a kidney to anyone in need at Calif.-based Riverside Community Hospital, kicking off the chain. The chain also included a Michigan man who agreed to donate his kidney to save his daughter's mother despite their acrimonious breakup (Sack, Times, 2/18).

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