- The Washington Times - Thursday, March 12, 2009

When Matthew Jones decided to donate a kidney to a stranger, the Michigan father of five had no idea he would be starting a lifesaving, “pay it forward” chain.

His kidney donation to a Phoenix woman in 2007 set off a long-running organ swap that resulted in 10 sick people getting new kidneys over a year. It hasn’t ended yet.

This chain of living donors and others like it could help increase the number of kidney transplants, lead to better matches that will increase survival and even reduce spending on costly, long-term dialysis, said the Ohio doctor behind the effort.

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“My dream would be that we eliminate the waiting list because we could turn every altruistic donor into 100 transplants,” said Dr. Michael Rees, a transplant surgeon at University of Toledo Medical Center.

Dr. Rees founded the Alliance for Paired Donation, which orchestrated the now 10-person transplant chain first begun by Mr. Jones and reported in Thursday’s New England Journal of Medicine.

A half-dozen other transplant groups have started similar programs, and the organization the federal government pays to oversee all U.S. organ transplants is developing its own national system.

Such efforts are needed, with the national waiting list for kidneys growing quickly because of the epidemic of overweight Americans with diabetes and high blood pressure, which damage kidneys.

Transplants from living donors accounted for more than a third of the 16,514 kidney transplants last year. Meanwhile, more than 78,000 Americans were waiting for a kidney and more than 4,000 died waiting in 2008.

Elizabeth Sleeman of the United Network for Organ Sharing (UNOS), which runs the federal transplant system, cites estimates that paired donor chains could lead to 1,000 to 2,000 more kidney transplants a year.

Later this year, UNOS plans to do a test run of matches among two-donor pairs - two kidney patients, each with an incompatible donor who matches the other patient. She hopes by late 2010 to be doing both donor pairs and chains nationally.

The program Dr. Rees started now includes more than 70 of the 244 U.S. centers with kidney transplant programs. Here’s how his 10-person donor chain worked:

Mr. Jones, who lives in Petoskey, Mich., heard a news report about a man giving a kidney to a stranger and thought he would like to do that, too. He worked with a transplant center in Buffalo, N.Y., but no match worked out.

He ultimately was referred to Dr. Rees, who was trying to devise a sophisticated living-donor pairing system. Dr. Rees’ father, a computer programmer, had developed donor matching software.

It paired Mr. Jones, 30, with Barb Bunnell, a 53-year-old Arizona woman whose husband wanted to donate a kidney but was incompatible.

Ignoring pleas from relatives to think of his children and drop the idea, Mr. Jones flew to Arizona for medical tests, taking his wife Meghan with him. Her staunch opposition vanished once she met Mrs. Bunnell.

The surgery was done July 18, 2007. The cost of the operation and Mr. Jones’ travel were paid by Mrs. Bunnell’s insurance.

Mrs. Bunnell’s husband, Ron, then became what Dr. Rees thinks is the world’s first “bridge” donor, meaning his kidney donation was made later. Usually, paired transplants are done at the same time, with relatives agreeing to donate a kidney to a compatible stranger in exchange for a kidney for their loved one. That way donors can’t back out.

Mr. Bunnell was on a plane a week later to give his kidney to Angie Heckman, 32, of Toledo. She’s a waitress at a bar owned by her mother, Laurie Sarvo. Mrs. Sarvo then gave a kidney to a woman in Columbus, Ohio, whose daughter then became the fourth donor in the chain. Then, on it ran, through patient-donor pairs.

The last operation was done last March, with a 60-year-old woman in Toledo getting a kidney from a Baltimore donor. That recipient’s daughter wants to donate a kidney, but a match hasn’t worked out yet.

“There’s a very good possibility that when I’m dead and gone, this chain will still be going on,” Mr. Jones said.

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