1000 kidney exchange transplants by NKR

Here's the announcement: National Kidney Registry Facilitates 1000th Transplant


"BABYLON, NY--(Marketwired - Mar 12, 2014) -  The National Kidney Registry announced the successful completion of their 1,000th paired exchange transplant. The 1,000th transplant, completed today at the University of Cincinnati, is part of a chain of 10 transplants. These transplants are taking place at other centers across the country including, UCSF Medical Center, Cleveland Clinic, Barnes-Jewish Hospital, New York-Presbyterian/Weill Cornell Medical Center, Lahey Clinic, Loyola University Medical Center, University of Minnesota Medical Center, Froedtert Hospital, and VCU Medical Center.

The NKR organized its first exchange transplants just over 6 years ago, in February of 2008, at New York-Presbyterian/Weill Cornell Medical Center. Commenting on the past six years, Dr. Sandi Kapur, Chief of Transplant Surgery and Director of the Kidney and Pancreas Transplant Program at New York-Presbyterian/Weill Cornell Medical Center and the Surgical Director of NKR, said, "These 1,000 transplants would not have been possible without the hard work and dedication of the transplant professionals at the 70 NKR member centers and the many altruistic donors who have given the gift of life to those suffering from kidney failure. Our program at New York-Presbyterian/Weill Cornell has been able to transplant over 100 patients with incompatible donors during this time period including many highly sensitized patients."

Dr. Jeffrey Veale, the Director of the UCLA Exchange Program, remarked, "We have seen the widespread adoption of paired exchange over the past six years which has allowed many patients with incompatible donors to receive a lifesaving transplant. We are thrilled that UCLA has been able to transplant over 100 patients with incompatible donors over the past six years and we look forward to working with the other NKR Member Centers to quickly surpass the 2,000 transplant milestone."

Dr. E. Steve Woodle, Director of the Division of Transplantation, holder of the William Altemeier Chair in Surgery at the University of Cincinnati, and a founder of one of the first multi-center kidney exchange programs in the United States, said, "When we first published the ethical and scientific foundations for kidney exchange programs in 1997, we hoped that someday we would have kidney exchange programs like the NKR. This accomplishment by the NKR exemplifies what dedicated leadership and membership can accomplish with kidney exchange. Our hats are off to those who built the NKR."

The goal of the NKR is to facilitate 1,000 transplants annually by 2020. Above is the history of NKR transplants.

About the National Kidney Registry

National Kidney Registry (www.kidneyregistry.org) is a nonprofit organization with the mission to save and improve the lives of people facing kidney failure by increasing the quality, speed, and number of living donor transplants. "
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Other posts about NKR

Utku Unver and Tayfun Sonmez talk about kidney exchange--video

Tayfun Sonmez and Utku Unver have a video on Boston College's YouTube channel:

"Published on Feb 23, 2014
Groundbreaking research by Boston College economists Tayfun Sönmez and Utku Ünver sparks hope for patients with kidney disease while advancing the University's philosophy of "men and women for others."
 Video Produced by Sean Casey "

Kidney exchange in San Antonio

Here's a news release from San Antonio, where Adam Bingaman is doing great things in kidney exchange:

SAN ANTONIO, Texas, Feb. 10, 2014/NEWS.GNOM.ES/ — Methodist Specialty and Transplant Hospital (MSTH), a campus of Methodist Hospital,  has performed its 250th  paired kidney exchange, setting a national record for a single hospital, while performing 10 lifesaving exchange transplants during the last week of January.

...

“Our philosophy is to help as many people as we can despite the challenges,” said Adam Bingaman, M.D., Ph.D., transplant surgeon and director of the program. “There are over 95,000 people on the kidney transplant waiting list and their chances of receiving a transplant are low, with an average wait of more than five years. Time is against people on dialysis – the sooner we can get them transplanted, the sooner they can return to good health.” Each year about 4,500 Americans die waiting for a kidney.

"The paired donor program at MSTH began in 2008 and has helped to pioneer the field of paired donation, successfully transplanting patients from across the U.S. and international pairs from Canada and Italy. The program’s success hinges on a team approach along with a world-class immunology laboratory. “Our group likes a challenge,” Bingaman said when talking about difficult-to-match patients who have travelled from near and far to receive exchange transplants in San Antonio. “We never get tired of giving folks their lives back, free from a dialysis machine.

"“A special emphasis is on blood type and antibody matching,” he continued. “We ensure each exchange recipient receives a kidney from a donor who is a complete or very close match, often making it unnecessary to utilize high-risk desensitization therapies to enable a transplant between incompatible pairs.”

WSJ: "I gave away a kidney, would you sell one?"

Dimitri Linde, a non-directed donor who started a kidney exchange chain writes in the WSJ yesterday:

I Gave Away a Kidney. Would You Sell One?

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"To obviate the kidney shortage, we should heed the recommendation of Nobel Prize-winning economist Gary Becker and others by making it legal to compensate donors. Currently, the National Organ Transplant Act bans the "sale" of any human organs in the U.S. Those who oppose compensation object to its ramifications for donors and society. They argue that the poor will be exploited, and that people should give out of the goodness of their hearts.

But these lofty sentiments ignore the fact that 18 transplant candidates die each day. As the legal scholar Richard Epstein has put it: "Only a bioethicist could prefer a world in which we have 1,000 altruists per annum and over 6,500 excess deaths over one in which we have no altruists and no excess deaths."

Yet absent such policy changes, which have little traction in Washington, right now transplant chains are the best tool to facilitate donations. Chains begin with a would-be recipient identifying a donor—say, a man with polycystic kidney disease and his wife. In most cases, a potential donor doesn't have a compatible blood and tissue type with the intended recipient, so this spousal pair would likely be a poor match. (Incompatibility can marginalize the life span of the transplant, or preclude the body from accepting it at all.)

That's where organizations like the National Kidney Registry, a nonprofit computerized matching service, come in. The NKR and similar nonprofits work with hospitals across the U.S. to create large national exchanges, linking incompatible and poorly compatible pairs to highly compatible counterparts elsewhere. Additionally, by working with living donors, these matching services furnish kidneys that endure, on average, twice as long as equally compatible cadaver transplants.

Through groups like NKR, altruistic donors—people willing to donate to an anonymous person—initiate "donor chains," catalyzing multiple donations. Inspired by reading about a 60-person chain begun by such a donor, I entrusted the NKR to select my recipient. Their software churned up a highly compatible match for me more than a thousand miles away. Concurrent with receiving a kidney, my recipient's incompatible donor gave to a commensurately strong match. A courier delivered this donor's organ to a third hospital in yet another region of the country, completing the exchanges."

Perfect Strangers: kidney donation movie

I went to see Perfect Strangers last night at Stanford, by Stanford's documentary filmmaker Jan Krawitz.
It was followed by a panel discussion by Krawitz, Stanford philosopher Debra Satz, and two non-directed kidney donors, one of whom was the main character in the film. Both initiated non-directed donor chains.

The other donor was the subject of this 2011 blog post A kidney donor argues that selling kidneys should be legal.

Kidney exchange at University of Alabama at Birmingham

UAB Launches Paired Exchange and Incompatible Kidney Transplant Program

Kidney Exchange at Alliance for Paired Donation nominated for Edelman Prize in OR

Here's the press release, which states in part:

CATONSVILLE, MD, December 17, 2013 – The Institute for Operations Research and the Management Sciences (INFORMS®) proudly announces the six finalist organizations that will compete for the 2014 INFORMS Franz Edelman Prize. The Prize is the world’s most prestigious recognition for excellence in applying advanced analytics to benefit business and humanitarian outcomes. 

This year’s finalists are:

1. Twitter, with Stanford University, for “The ‘Who to Follow’ System at Twitter: Strategy, Algorithms, and Revenue Impact.”
2. The U.S. Centers for Disease Control and Prevention (CDC), with Kid Risk, Inc.,for “Using Integrated Analytical Models to Support Global Health Policies to Manage Vaccine Preventable Diseases: Polio Eradication and Beyond.”
3. The Energy Authority for “Hydroelectric Generation and Water Routing Optimizer.”
4. Grady Memorial Hospital, with the Georgia Institute of Technology,for “Modeling and Optimizing Emergency Department Workflow.”
5. Kidney Exchange at the Alliance for Paired Donation, with Stanford and MIT,for “Kidney Exchange.”
6. NBN Company, with Biarri, for “Fiber Optic Network Optimization at NBN Co.”

Now in its 43rd year, the INFORMS Franz Edelman Prize competition recognizes outstanding examples of analytics and operations research projects that transform companies, entire industries and people’s lives. Using innovative advanced analytical methods, the teams were instrumental in helping their respective institutions make better decisions, providing a disciplined way by which management can improve organizational performance in a wide variety of situations and across both public and private organizations.  

INFORMS Franz Edelman finalist teams have contributed over $200 billion in benefits to business and the public interest. The 2014 INFORMS Franz Edelman Prize finalists were chosen after a rigorous review by accomplished verifiers, all of whom have led successful analytics projects. The verifiers come from IBM, BNSF, Bank of America, Verizon Wireless, HP, Eastman Chemical, Columbia University, Carnegie Mellon University, University of Chicago, the University of Chile, and other noted organizations. Finalists are chosen on the merits of how analytics methodologies were applied to solve problems, reduce costs, or otherwise improve results in real-world environments. 

Update: note that the press release mistakenly omits Boston College from the institutions associated with kidney exchange.

Kidney exchange in Vienna

Here's an article discussing a simple paired exchange in Vienna, with plans to move soon to chains. It sounds like the last link in the chain of ideas and computer code led from Australia to Austria.

"The problem of incompatibility is solved by pairs (married couples, siblings, mother and child, friends, etc.) being selected using a new computing algorithm, which was developed in Australia and evaluated at the MedUni Vienna in a newly published pilot study, in which the organ donation is made possible in a "crossover." This means that each donor, whose kidney is not suitable for their own intended recipient, donates the organ to a stranger, the recipient in another pair and vice versa."