November 14, 2018
Partnership enables 6-way "chain," connects strangers and results in
3 lifesaving kidney transplants
KANSAS CITY, Mo. — This story started as 4 separate stories. A pediatric intensive care unit (PICU) nurse at Children's Mercy, who had been family friends with a longtime patient, was ready to donate her kidney when the patient needed a transplant.
Around the same time, a Baldwin City, Kansas, triathlete with a huge heart was determined to donate a kidney after learning about living kidney donation. When doctors at Children's Mercy and The University of Kansas Health System realized the triathlete's kidney was a similar match – if not better – for the Children's Mercy patient, and that the nurse could in turn donate to someone else, the "chain" reaction began.
One of the living donors matched a Wichita man who had been waiting 4 years on dialysis for a kidney. His mother wasn't a match for him, but her kidney was perfect for a Savonburg, Kansas, man who'd been on the waiting list for 2 years.
A total of 6 surgeries took place at Children's Mercy and The University of Kansas Health System on Monday, October 29 and Tuesday, October 30 – 3 to remove the living donors' kidneys and 3 to implant the gift of life into their waiting recipients. Living kidney chains begin with a single altruistic person willing to give their healthy kidney to someone in need – often a complete stranger. Through the thoughtful pairings of this chain, 3 people were able to get the gift of life instead of only 1. This was also the first time a pediatric patient at Children's Mercy was involved in a transplant chain.
"When we considered this opportunity, I spoke to the nephrologist at The University of Kansas Health System about the need to be assured that having our nurse, Christa, donate to a second person was not going to have a negative impact on Dayshanae (the pediatric patient) in terms of the donor/recipient match. And so we had to look very, very closely at the match between the altruistic donor and Dayshanae, and Christa and the second recipient, and we found the matches were favorable in both cases," says Bradley Warady, MD, director of the division of pediatric nephrology and director of dialysis and transplantation at Children's Mercy.
"This was a wonderful collaboration between Children's Mercy and The University of Kansas Health System," says Timothy Schmitt, MD, director of transplantation at The University of Kansas Health System. "And because of that, future chains will likely occur for other kids followed in Children's Mercy's end-stage kidney disease program. Our philosophy is to do whatever we can do to expedite successful transplantation in our kids and shorten their time on dialysis. This event and collaboration with Children's Mercy illustrates how creative transplant teams can get to make sure a living donor's desire to help a friend, family or even a stranger is met."
"The gift of life donated by living donors is always inspiring," says Sean Kumer, MD, PhD, physician vice president of perioperative services at The University of Kansas Health System. "While our transplant teams have the confidence to do what it takes to benefit our patients, none of this would have been possible without the selfless actions of the organ donors."
"Living related kidney transplantation is still the best option today for providing long-term kidney survival for our pediatric recipients, with half of these kidneys surviving more than 15 years. Unfortunately, a lot of children do not have access to a related living kidney transplant because they do not have a suitable donor," says Walter Andrews, MD, surgeon at Children's Mercy. "At Children's Mercy, we have several children who are very difficult matches for even a deceased kidney. Paired donation provides them with hope that a compatible kidney can be found."
That motivating factor led staff at both hospitals to do whatever was necessary to create this successful chain.
At any given time, around 600,000 people are on dialysis and nearly 100,00 are on the waiting list for a kidney transplant. Yet fewer than 20,000 transplants were done in 2017, of which only 5,835 involved living donors.
Between the 2 hospitals, hundreds of patients are listed for a kidney transplant and anxiously await a kidney from a deceased donor. The collaboration on this living donor transplant chain and future chains that target the best matches between donors and recipients, will allow more patients – and specifically more pediatric patients – to get the lifesaving transplant they need in much less time.
And there's yet another story as the perfect postscript: The nurse who wanted to donate her kidney to her friend, but was willing to give it to a stranger, also became the first recipient of the "Warady Benefit" at Children's Mercy. Honoring Dr. Warady, who has championed organ donation throughout his career, the benefit allows employees who become living donors to use up to 40 hours of additional extended illness time as they recover from surgery.
About Children's Mercy Kansas City
Founded in 1897, Children's Mercy is one of the nation's top pediatric medical centers. With not-for-profit hospitals in Missouri and Kansas, and numerous specialty clinics in both states, Children's Mercy provides the highest level of care for children from birth through the age of 21. U.S. News & World Report has repeatedly ranked Children's Mercy as one of "America's Best Children's Hospitals." For the fourth time in a row, Children's Mercy has achieved Magnet nursing designation, awarded to fewer than 7% of all hospitals nationally, for excellence in quality care. Its faculty of more than 700 pediatric subspecialists and researchers across more than 40 subspecialties are actively involved in clinical care, pediatric research and educating the next generation of pediatric subspecialists. Thanks to generous philanthropic and volunteer support, Children's Mercy provides medical care to every child who passes through its doors, regardless of a family's ability to pay.
About The University of Kansas Health System
The University of Kansas Health System is the region's premier academic medical system, providing a full range of care. It includes The University of Kansas Physicians, the largest multispecialty physician group in the region. The health system is affiliated with the University of Kansas Schools of Medicine, Nursing and Health Professions, and their leading-edge research projects. In the Kansas City metro area, the health system offers more than 80 hospital and clinic locations, including the main hospital in Kansas City, Kansas, and Indian Creek Campus in Overland Park. Its hospitals in the Kansas City metro contain 852 staffed beds (plus 24 bassinets) and serve more than 39,000 inpatients annually. The University of Kansas Hospital in Kansas City has received Magnet nursing designation 3 times in a row for the highest level of care. It has also ranked for more than a decade on U.S. News & World Report's Best Hospitals lists, currently ranking in 9 medical and surgical specialties. It provides the region's only nationally verified pediatric and adult burn center and nationally verified Level I Trauma Center, as well as a leading transplant program in liver, pancreas, kidney, heart and blood and marrow. The cancer program is part of The University of Kansas Cancer Center, one of 70 National Cancer Institute-designated cancer centers. In addition to its Kansas City operations, the health system includes locations in Hays, Topeka, Great Bend and Larned. The health system receives no state or local appropriations, instead relying on operating revenue, bonding authority and philanthropy.