Tuesday, March 30, 2010

Loyola Program a Radical Shift in Living Donor Kidney Transplants

In a first, four people step forward to donate kidneys to complete strangers across the country with no strings attached

MAYWOOD, Ill. -- It's extremely rare when someone asking for nothing in return steps forward at a hospital and offers to donate a kidney to a complete stranger.

What's rarer still is what has happened at Loyola University Medical Center -- four people have stepped forward and offered to donate kidneys to four complete strangers and none have asked for a thing in return.

"This is completely unique and totally unheard of," said Garet Hill, founder of the nonprofit National Kidney Registry, which coordinated the donations. "We have never had four donors from one institution come forward at one time to offer up kidneys for donation with no strings attached."

The selfless acts by the four have helped Loyola launch its Pay-it-Forward Kidney Transplant Program, the first of its kind in the Midwest, and the largest number of altruistic donors to ever begin such a program in the United States.

"This represents a spectacular improvement in our nation’s approach to living-donor kidney donation," said Loyola kidney transplant surgeon Dr. John Milner, who helped spearhead the initiative. "It's a huge opportunity to expand the pool of donors and dramatically reduce the times people spend waiting on transplant lists for a new kidney."

The donors are Christina Lamb, 45, of Melrose Park, Ill.; Cynthia Ruiz, 22, of La Grange, Ill.; Jodi Tamen, 45, of West Frankfort, Ill., and Tim Joos, 53, of St. Charles, Ill.

A Pay-it-Forward kidney transplant begins when an altruistic donor steps forward and offers to donate a kidney to a stranger, beginning a chain. The donor's kidney is then given to a compatible transplant candidate who has an incompatible donor who then agrees to give a kidney to a third person with an incompatible donor, and so on. Potentially, the chain can go on forever.

"It's just like in the movie 'Pay It Forward' when someone flips you the keys to a brand-new Jaguar and then walks away," Milner said.

Currently, more than 82,000 people are on the waiting list for a kidney transplant, according to the United Network for Organ Sharing (UNOS), which maintains the national waiting list. The average wait time is five to seven years. By utilizing a powerful complex computer algorithm, the Pay-it-Forward concept rapidly links up compatible donors and recipients from across the nation with the goal of cutting that wait time in half.

"On average, each altruistic donation has led to six transplants so potentially Loyola’s four donors could result in 24 people receiving transplants very soon," Hill said.

Besides dramatically increasing the number of transplants that can take place, the Pay-it-Forward program represents a radical shift in how kidney transplants are performed.

"What traditionally happens is that a hospital will take an altruistic donor and keep that donor within its walls and get only one transplant done," Milner said. "We, however, view these donors as national treasures and not institutional commodities to not be shared. We will offer our donors to any other hospital with the goal of getting more people transplanted."

A Pay-it-Forward kidney transplant can easily be confused with a paired donation in which a transplant candidate has a willing donor who is incompatible. In this instance, the pair is matched with a compatible pair in the same situation and they go on to swap kidneys.

However, a pair donation has a major limitation. The surgeries have to be performed simultaneously in the same hospital since a donor could decline to donate after their partner receives a kidney from the other pair.

"The advantage of a Pay-it-Forward transplant is that the surgeries don't have to take place simultaneously or in the same hospital," said Loyola transplant surgeon Dr. David Holt who also helped spearhead the Pay-it-Forward concept at Loyola. "One of our donor’s kidneys will be transplanted in a patient in Philadelphia and another in a patient in Los Angeles. Also, let's say a donor drops out. No biggie. We'll start another chain."

Including the patients in Los Angeles and Philadelphia, Loyola’s Pay-it-Forward program has already demonstrated its remarkable potential. Less than two weeks ago, Robert Rylko of Rockford received a kidney from Lamb.

Also, the program may have come just in time for 19-year-old Melissa Clynes of Florissant, Mo. Melissa’s kidneys were destroyed by medication she has taken since infancy when she had a heart transplant. Three years ago she received a kidney from her mother Mary, but a virus caused the transplant to fail. Since then, Melissa has had a difficult time finding a match until recently when Ruiz, 22 was found to be compatible with her. The transplant took place on Monday, March 29, at Loyola. As part of the program, Melissa’s sister, Sarah, will donate her kidney to a stranger in a few days.

"Two weeks ago I was just devastated. I had already sent out 11,000 flyers and set up a Web site but nobody matched up until I Googled, 'How to find a live kidney donor and found the National Kidney Registry,'" Mary Clynes said.

For the first time, Robert Rylko and his family and the family of Melissa Clynes will meet the altruistic strangers who donated kidneys to Robert and Melissa. The meeting will take place at 10 a.m., Tuesday, March 30, at Loyola University Medical Center in Maywood, Ill.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.