Wednesday, December 26, 2012

Kidney exchange in Canada

Moving to chains in Canada too...

Heartbeat: A chain of faith, a gift of life: Revolutionary organ exchange program can involve a domino chain of up to 10 people across Canada, and it drastically reduces wait times for transplant recipients

 "Nemeth was feeling increasingly ill and didn’t have that long to wait.

"Luckily, she didn’t have to. In early 2012, at her doctor’s urging, she joined the Living Donor Paired Exchange program.

"In the registry, donor-recipient pairs whose organs are incompatible with each other can be matched with others in the same situation and the organs swapped to complete transplants. There are Good Samaritans — non-directed anonymous donors — who simply donate a kidney out of altruism also entered in the registry. Algorithms determine matches to optimize use of rare blood and antibody types: swaps that result can involve up to five-pair chains — up to 10 people in cities across Canada all intricately linked in a complex “domino” transplant.

"The registry was founded as a pilot project in three provinces, including B.C., in 2009. It has since gone national and is overseen by Canadian Blood Services, which conducts three (formerly four) searches or “runs” a year.

"To date, there are about 145 registered pairs.

"More than 140 transplants have been performed, with the first cross-country multi-hospital swap in June 2009. Nemeth’s own chain involved three pairs: done at St. Paul’s and in Winnipeg.

"The program not only shortens waits and saves lives, but it also saves money: dialysis costs $60,000 a year while a kidney transplant is around $25,000 plus $6,000 a year for medication.

"Even before the national registry, provincial hospitals like St. Paul’s were doing ad hoc local swaps for just these reasons.

“We were basically doing these on the back of an envelope,” Dr. Landsberg said, adding St. Paul’s did its first regional domino transplant around 2006.

"But the national registry has been a true game-changer. Because of it, he said, “the number of difficult to match patients who were stacked on that wait-list and who I predicted would be on there forever have been able to get transplants.”

"And despite the tenuous nature of the chains, so far, he said, “We’ve never had a donor back out.”

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