- Associated Press - Wednesday, December 17, 2014

INDIANAPOLIS (AP) - The two kidneys could have passed in the air somewhere over Tennessee.

Dinah Sampson’s organ traveled last week to a South Carolina transplant center, where surgeons then placed it in the body of a person Sampson had never met.

At about the same time Indianapolis surgeons were removing her kidney, a stranger in South Carolina underwent the same procedure there. That kidney would then have to be ferried to the airport and flown to Indianapolis.

Just as Sampson’s kidney was transplanted into the South Carolina patient, surgeons in a St. Vincent operating room replaced the failing kidney of Sampson’s father with one that had started the day in a South Carolina stranger’s body.

Two healthy donors, two sick recipients. In organ transplant circles, the whole procedure is called a kidney swap. But to Sampson and her father, Ed Hanson, a better phrase might be lifesaver.

For the past seven years, Hanson’s kidney function had been failing. His nephrologist told him to expect to need dialysis soon. In April, the day came and the Porter County man started at-home peritoneal dialysis.

The alarm on the machine he used at night went off every two hours, interrupting his sleep. So, he switched to manual dialysis, which required him to hook up to an IV pole four times a day.

In June, St. Vincent came to his local dialysis center to pitch their relatively new transplant program, which they offered in collaboration with Cleveland Clinic surgeons. Hanson, 66, was intrigued.

As Hanson started preliminary testing for a transplant, his daughter Dinah Sampson, 36, stepped forward to give him a kidney of her own.

“I feel like it’s just a foregone conclusion, anything I can do to help him,” she told The Indianapolis Star (https://indy.st/139RFiL ). “I was open to anything that could give him a kidney.”

On Aug. 21, Hanson was approved to go on the lengthy waiting list for a kidney from a deceased donor.

The next day, Sampson started her own testing. She knew it would be a long shot. Her blood type was A and his O, making them most likely incompatible. But about 20 percent of people with blood type A can donate to those with O, said Tami Rader, living donor transplant coordinator at St. Vincent Health. On Sept. 5, the family learned that Sampson did not fall within that 20 percent.

Another possibility arose: Just the previous March, St. Vincent Health had joined the National Kidney Registry, an organization that strives to match living donors with recipients.

There are about 101,835 people on the waiting list for a kidney, according to the Organ Procurement and Transplantation Network. Most people in Indiana wait from two to four years for a kidney, Rader said.

Joining the National Kidney Registry could cut that time for those waiting who had family members or friends willing to donate their organ, Rader said.

“This is one way we felt like we could expand and help our patients who are listed get a kidney a little sooner,” she said.

St. Vincent had offered this option to other donor-recipient pairs before, but in some cases, the recipient wasn’t ready. In others, the donor wasn’t accepted, Rader said.

One other father-daughter pair almost enrolled in the registry, but the father received the offer of a kidney from a deceased person and said he’d prefer not to have his daughter lose her kidney unless it was necessary, Rader said.

So Hanson and Sampson could be the first.

Seven years ago, an East Coast businessman planned to donate his kidney to his 10-year-old daughter only to learn just before the surgery that he would not be a good cross match. She received a kidney from a cousin instead. Realizing more help was needed, he decided to form the National Kidney Registry, which since then has facilitated more than 1,200 kidney swaps.

The simplest form of a kidney swap is a situation such as Hanson and Sampson’s in which one donor-recipient pair trades kidneys with another pair, said Joe Sinacore, director of education and development for the New York-based National Kidney Registry.

More common, however, is a chain that kicks off with a good Samaritan donor, who donates to a stranger, who has a non-compatible willing donor. That person’s kidney goes to the next person and so on. The longest chain the registry coordinated consisted of 30 donations in 2012, Sinacore said.

“Chains are more common than swaps,” Sinacore said. “Chains are more durable. In a closed-loop exchange, if any one party cannot move forward with the swap, you have to throw everybody back in the pool.”

While most patients in the registry received kidneys in less than three months, some prove harder to match. The only way to tell how long an individual patient will wait is to enroll.

After counseling Hanson and his daughter that they might have to wait a while, Rader started the process of enrolling the two.

Hanson’s testing had revealed no antibodies that could it make difficult for him to accept a kidney from certain donors, Rader said.

When they joined the registry, Hanson came up with about five potential donors that could work for him. Sampson, however, had no recipients that matched her makeup.

The registry has about 350 to 400 pairs on its list - donors and recipients affiliated with transplant programs at about 75 hospitals across the country, Sinacore said. Hospitals pay a small fee to join the registry. New pairs are entered almost every day, if not several times a day.

“It’s very fluid. If you get one more pair in a pool, if that pair’s donor happens to be a miracle match, it could create a huge chain,” Sinacore said. “It’s kind of fascinating to see how quickly things can take off.”

No one was expecting it to happen so soon. Both Hanson and figured it would take about a year.

Then on Nov. 18, Rader received an email, pointing her to a potential match. On Wednesday, she confirmed the match on the registry. A few more tests for donors and recipients and by Nov. 26, the date was set.

On Dec. 11, Sampson’s surgery was scheduled to begin at 7 a.m., just as the donor in South Carolina was also going under the knife.

A courier came to pick up Sampson’s kidney. In South Carolina, a similar process occurred with the kidney headed for Hanson’s body. Often, organs fly cargo, but in this case because a plane change is needed, couriers took the kidneys as carry-on.

As the courier left with Sampson’s kidney, Dr. Alvin Wee, the transplant surgeon, and his partner closed up Sampson, taking extra care.

“Living donors are special, they’re very selfless, you want to give your time to them,” said Wee, who operates at St. Vincent but is an employee of the Cleveland Clinic.

The courier and Sampson’s kidney flew Delta, connecting through Charlotte. The donated kidney traveled USAir, connecting through Atlanta.

Wee had left the operating room after the morning surgery to spend his day seeing patients in his clinic. But by the time Hanson’s new kidney arrived, Wee was ready to go for the transplant part of the operation.

Within a few hours, St. Vincent’s first kidney swap transplant operation had ended.

Sampson, a South Bend attorney, has left the hospital to return to her family, which includes two children under five.

She’s not sure if she’ll ever learn more about the person who gave her father a kidney or where her own kidney wound up once it left her body. Organ transplant experts recommend that donors and recipients wait about a year to decide whether or not to contact each other and to correspond a few times before meeting in person.

For now, Sampson’s just glad she had the chance.

“I feel maybe it’s even better than a direct match because you get to help more than one person,” she said.

___

Information from: The Indianapolis Star, https://www.indystar.com


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