UCSF Joins Forces with CPMC for Rare 9-way Kidney Transplant Chain
For much of the Bay Area, June 4 was a day to root for the Golden State Warriors in the NBA Finals. But a different sort of drama was unfolding at UCSF Medical Center and California Pacific Medical Center, where medical teams embarked on a rare 18-person kidney transplant chain started by a Good Samaritan donor.
The chain may be the longest of its kind in a single city over a 36-hour time period.
“This has never been done before in the Bay Area,” said Dr. Stephen Tomlanovich, medical director of UCSF’s kidney transplant service. “Logistically, doing nine transplants in such a short period is pretty challenging. It is a huge undertaking.”
As part of the collaboration, a total of 18 donors and recipients underwent surgery in a little more than 36 hours, with nine people donating and nine receiving new kidneys. Couriers shuttled the organs back and forth between the two centers as the surgeries took place.
In addition to the chain, UCSF doctors also performed three separate living donor transplants during the same time period — making for a very busy two days at our center.
Why Are Transplant Chains Needed?
About 100,000 Americans and nearly 19,000 Californians are currently waiting for a kidney, according to the Organ Procurement and Transplantation Network. Some 5,200 of those patients are at UCSF’s transplant center, which has performed more transplants than any other U.S. program in its 51-year history.
In fact, the combined number of patients waiting for kidneys at UCSF and California Pacific Medical Center, or CPMC, accounts for about 7 percent of the total U.S. wait list.
While the wait times to receive a kidney from a deceased donor vary throughout the country, Bay Area patients often remain on the list for a minimum of around six to 10 years.
“I tell my patients their chances are only about one in five,” Tomlanovich said. “There’s an 80 percent chance that they’ll never be transplanted.”
As a result, many people with kidney disease look for a healthy relative or friend who is willing to donate. But those potential donors aren’t always a good match because of blood type or other more complex factors, such as immune system response.
Transplant chains form when incompatible pairs sign up with hospitals and organizations like the National Kidney Registry, which sifts through hundreds of donors and recipients to find appropriate matches. With advances in software, complex kidney exchanges or “chains” among as many as 60 individuals have become increasingly possible.
‘Out of the Goodness of Their Hearts’
Often an “altruistic donor,” a living person who donates his or her kidney to a stranger rather than a relative or friend, starts the chain.
“A chain often starts when someone off the street says, ‘I want to donate my kidney to somebody,'” said Dr. Ryutaro Hirose, a UCSF transplant surgeon. “They don’t have a friend or relative who needs a transplant. They’re just doing it out of the goodness of their heart.”
Reid Moran-Haywood, the altruistic donor who made UCSF and CPMC’s recent nine-way chain possible, said he became interested in kidney donation after hearing of an acquaintance’s struggle to find a match. Because of his excellent health and universal-donor blood type, the 56-year-old avid runner said he found the decision easy.
“I’m the lucky one: I’ve had a healthy life,” Moran-Haywood said. “I’m excited to help out. It’s very little sacrifice as far as I’m concerned.”
While the physical and mental screening process for altruistic donors remains extensive, doctors believe the long-term risks of living with just one kidney are low for healthy people.
Two San Francisco Hospitals Working Together
Transplant teams at UCSF and CPMC first discussed a possible collaboration months ago, and that dream became a reality after both hospitals began using the same software program to match donor and recipient pairs.
The software, called MatchGrid, enabled the two centers to combine patient data without compromising privacy and analyze possible matches far more quickly than was previously possible.
“We have two separate groups of patients in two hospitals, and we anonymously join them together and see if there are matches within the two programs,” said Dr. Steven Katznelson, medical director of CPMC’s kidney transplant program. “The more people in the pool, the more likely it is to find a match for any one of our patients.
“We both agree that we stand to serve our patients better by collaborating rather than competing,” he added.
Both centers expect the cooperation to continue and predict it will produce more large-scale kidney exchanges in the Bay Area.
A Patient’s Life Changed
Kidney recipient Helen Hillman is certainly grateful for the teamwork that made her transplant possible. About 15 years ago, the 69-year-old Walnut Creek resident learned that her kidneys were functioning at 50 percent of normal.
By 2013 Hillman spent every night hooked up to a dialysis machine. She had to give up beloved activities like traveling, Zumba classes and Pilates. Hillman also found it increasingly difficult to lift her 3-year-old granddaughter, though she could still manage her 6-month-old grandson.
Then Hillman’s former sister-in-law and dear friend, Cynthia Ginsburg, volunteered to donate a kidney about a year ago. The two women weren’t a match but joined UCSF’s wait list together.
Hillman received her new kidney on Friday, June 5.
“It’s going to give me a chance of a new life,” Hillman said before her surgery. “I haven’t done anything for two years — I haven’t traveled because the machine is about 60 pounds. I want to go to Eastern Europe, to Budapest, Russia.
“There are so many places that I want to go.”
Photos of Reid Moran-Haywood by Deanne Fitzmaurice. Photo of Dr. Andrew Posselt by Tom Seawell.
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