April 6, 2007

Massachusetts' first three-way kidney swap takes place at the MGH

"It's like I have a new extended family," says Good Samaritan organ donor Lisa Dubois. On Feb. 27, the mother of four donated her kidney to a stranger, setting off a domino effect that involved two incompatible donor-recipient pairs and a patient on the national kidney waiting list.

Dubois helped patient Ryan Clifford, who needed a kidney but was not a match with his mother, Collette Clifford. Collette was able to help her son by donating her kidney to another stranger, Renee Ravenelle. Renee's brother, Robert, was incompatible with his sibling, but he was able to donate a kidney to wait-listed patient Christopher Santamaria.

The start of Organ Donation Awareness Month in April draws attention to this historic exchange that took place partly at the MGH. The successful three-way kidney swap is a first in New England.

Made possible in part by doctors, nurses and coordinators at the MGH, as well as staff of the New England Organ Bank (NEOB) and its New England Program for Kidney Exchange (NEPKE), the simultaneous transplant operations maximized
the number of people helped through the gift of organ donation.

"The success of this exchange is a testament to the importance of organ donation," says Nina Tolkoff-Rubin, MD, medical director of the MGH Renal Transplantation Program. "Careful planning by the NEOB and NEPKE allowed three patients to go home with new, healthy kidneys. Otherwise, the patients could have remainedÊon dialysis for years waiting for a kidney."

The donors and recipients of this exchange met for the first time March 21 during a media event at the NEOB. Santamaria and Robert Ravenelle joked that they had met once before in the MGH halls, when they both had been up and walking hours after the procedure, not knowing their intimate connection through this exchange.
They were among the four patients who had undergone surgery at the MGH by a team led by Dicken Ko, MD, surgical director of the MGH Renal Transplantation Program. "We're very pleased with the success of these transplants, which were the result of a tremendous team effort," says Ko. "Hopefully other potential donors will know that there are many options to donate even when they are not compatible with their intended recipients." The other donor-recipient pair received care at Beth Israel Deaconess Medical Center.

"It takes a village to make this happen, and the teamwork involved starts with the donors," says Tolkoff-Rubin. Other members of the MGH care team who were involved include Waichi Wong, MD, of MGH Renal Associates; Jayne Galley-Reilley, RN, renal transplant coordinator; and Nahel Elias, MD; Tatsuo Kawai, MD; and Martin Hertl, MD, all of Transplant Surgery.

For more information about the MGH Renal Transplantation Program, contact Galley-Reilley at jgalleyreilley@partners.org.

From left, Renee Ravenelle, Dubois, Ryan Clifford, Collette Clifford, Tolkoff-Rubin, Robert Ravenelle, Santamaria, Galley-Reilley, Wong, Ko, Allison Siebert of Transplant Surgery and Elias