Three Southeast Michigan Health Systems Collaborate for Historic 3-way Kidney Swap

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Kidney paired donations: Another viable option for those awaiting a transplant

Six lives, three kidneys and one goal. Thanks to a collaborative effort by three area health systems, the lives of six Michigan residents have changed for the better through an ultimate display of paying it forward: a historic 3-way kidney swap.

Three individuals needed life-saving kidney transplants. While they each had willing donors, they were not good matches. Kidney transplant teams from Henry Ford Health System, Beaumont Health and University of Michigan Health System worked together with the Organ Procurement and Transplantation Network to find a kidney for each of their patients through a “paired donation” program. This program allows patients to sign up to receive a kidney from a living donor of a compatible blood type by having a donor give a kidney to another patient through a paired kidney exchange.

In a rare turn of events, the Beaumont, Henry Ford and U-M patients and their donors matched with each other, setting the wheels in motion for a kidney exchange involving three major kidney transplant centers in Southeast Michigan.

After nearly two months of meticulous planning, the organ procurement procedures and kidney transplants took place on July 22 in Ann Arbor, Detroit and Royal Oak. On Oct. 22, three months after their surgeries, the recipients met their donors for the first time.

Paired donation

According to the United Network of Organ Sharing, or UNOS, which manages the Organ Procurement and Transplantation Network, paired donation provides an option for patients who have a living donor offering a kidney, but the kidney is incompatible. UNOS, working through the nation’s transplant system and organ donor list, then finds someone the donor will match -- and a matching donor for the original patient.

So far, nearly 4000 people have participated in paired donation since the idea originated at the University of Chicago in 1997 and was developed in the early 2000s, explains transplant surgeon Lauren Malinzak, M.D., director of the Kidney Paired Donation Program at the Henry Ford Transplant Institute at Henry Ford Hospital.

“These kidney chains have linked thousands of people," she says. "Paired kidney donation can shave months off the wait list for patients. And with the crucial need for donor kidneys, it can provide life-saving options. We’re excited to be part of the first one linking our three hospital systems in Southeast Michigan.”

Benefits of kidney paired donation include:

• Recipient receives a compatible, living donor kidney, that, on average, will last longer than a deceased donor kidney
• Recipient may have a shorter wait for transplant
• Recipient may also need less immunosuppressant drug therapy
• Recipient may receive a transplant before dialysis
• Rewarding for donor as family/friends benefit from their donation

Logistics

With three pairs of patients from three medical centers, there was a great deal of planning and coordination to ensure the six procedures were done in a safe and timely manner. On Wednesday, July 22, all three donor kidneys were en route to their recipient’s medical centers between 11 a.m. and 1 p.m.

• 11 a.m. Tricia Meyer’s kidney was transported from the U of M Medical Center in Ann Arbor to Henry Ford Hospital in Detroit for Kim Yarbrough
• 11:39 a.m. Tom Ash’s kidney was transported from Beaumont – Royal Oak to U of M Medical Center in Ann Arbor for David Hostetler
• 1 p.m. Markeshia Valentine’s kidney was transported from Henry Ford Hospital in Detroit to Beaumont – Royal Oak for Lisa Ash

“This is a great example of what the gift of life can do," says John Magee, M.D., transplant surgeon and director of the University of Michigan Transplant Center. "The impact of the extra effort associated with paired donation is well worth it. The University of Michigan is proud to be a part of this historic chain, and we hope to work with our partners at Beaumont and Henry Ford in the future on many more kidney paired donations – the more donors and transplant centers that participate in this program, the better!”

Post-op and beyond

What does the future hold for both the kidney recipients and donors? Dilip Samarapungavan, M.D., medical director, Multi-Organ Transplant Program, Beaumont Health, explains.

“For the recipients of this precious gift, the journey is just beginning," says Dr. Samarapungavan. "Even as they recover from surgery, there are frequent visits to the clinic, blood tests, ultrasounds, biopsies and the lifelong commitment to a complex and potent medication regime. Vigilance and monitoring are the price for a successful outcome.”

As for the donors, Dr. Samarapungavan says, “They typically resume their normal lifestyles. However, vigilance is important for donors, too: a comprehensive health screening at least once a year for the rest of their lives. Interestingly, kidney donors usually outlive their counterparts in the general population.”

Importance of kidney donations

On Oct. 16, 2,954 people were waiting for a kidney transplant at a center in Michigan. To increase the availability of live donor kidneys, the Organ Procurement and Transplantation Network has a Kidney Paired Donation Pilot Program, one of a number of programs to facilitate paired kidney donation. Nationwide, 155 hospital systems with kidney programs participate in OPTN's program, including Beaumont Hospital – Royal Oak, Henry Ford Health System and University of Michigan Medical Center. Since the program’s inception, 155 recipients have received a paired kidney donation through the OPTN program.

“The need is great," says Dr. Samarapungavan. "In the long term, a deceased donor kidney on average lasts about 10-11 years, while a living donor kidney may last for 20-25 years. Living kidney donations indeed save lives. Paired donation offers this extraordinary opportunity where otherwise it may not be feasible to proceed with a live kidney donation.”

Henry Ford patient Kim Yarbrough, 52, of Detroit, praises her daughter, Markeshia Valentine, 32, of Dearborn Heights, for the donation that changed her life.

“Oh, my God, first, Markeshia is my hero," says Mrs. Yarbrough. "Without her, I couldn’t even begin to get in the program. And the individual who gave me the kidney is also my hero. And I just really, really feel so blessed.”

Headaches led Mrs. Yarbrough, a mortgage specialist, to the doctor in 2011. Doctors told her she had uncontrolled high blood pressure, a leading cause of kidney disease. But the lifestyle changes she made weren’t enough to save her kidney. The mother and stepmother of five and grandmother of six started dialysis on Dec. 10, 2013. Family members began testing to see if could donate a kidney, but no one matched.

Then she learned about Henry Ford Transplant Institute’s Paired Kidney Donation Program. Her daughter, who works in accounts payable at a nursing care facility, volunteered. Mrs. Valentine said the prospect of her mother waiting for years for a kidney led her to donate.

“It was hard because I have three children, and I have to take care of them,” explains Mrs. Valentine. “And hypertension runs in our family. So there were a lot of decisions I had to make.”

Dr. Malinzak removed Mrs. Valentine’s kidney, which was transported to Beaumont Hospital in Royal Oak for implantation. At about the same time, a kidney arrived from a donor at the University of Michigan Health System Hospital in Ann Arbor and was transplanted into Mrs. Yarbrough by Henry Ford Senior Staff Transplant Surgeon Jason Denny.

Mrs. Yarbrough’s transplanted kidney is functioning beautifully, making her one of more than a dozen patients at Henry Ford Hospital to receive a kidney through paired donation. Henry Ford Health System’s Transplant Institute performed 120 kidney transplants in 2014.

“We are aggressive when it comes to finding organs for patients of the Henry Ford Transplant Institute – their lives depend on it,” says Dr. Malinzak. “And we’re excited for all the patients about the success of this chain.”

Mrs. Yarbrough is headed back to church as soon as possible, and she hopes to return to her job processing mortgages at Quicken Loans in 2016. She also wants to make up for her grandchildren’s games and cheerleading competitions she missed while she was sick.

“I can start my life back over,” she says.

About the Henry Ford Transplant Institute

The Henry Ford Transplant Institute at Henry Ford Hospital is the most comprehensive multi-organ transplant program in Michigan. The program provides superior outcomes in transplantation of the kidney, liver, pancreas, intestine, lung and heart, as well as bone marrow stem cells. It is part of Henry Ford Health System, one of the largest and most comprehensive integrated health care systems in the United States, as well as a national leader in clinical care, research and education. To learn more, visit The Henry Ford Transplant Institute.

Note: Donor and recipient profiles are available for each pair.

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