Emory Transplant Surgeons Participate in Second Largest Kidney Swap in History

Dr. Nicole Turgeon with kidney swap recipient Troy Milford and donor Robert Poole.

July 2013

Photo: Dr. Nicole Turgeon with kidney swap recipient Troy Milford and donor Robert Poole.

The world's second largest kidney swap in history, and the largest kidney swap to be concluded in less than 40 days, began in Memphis, TN, on April 30, 2013, with a donation from a Good Samaritan donor, also known as an altruistic donor, and ended just five weeks later, on June 5, in Cleveland, OH. Named "Chain 221" by the National Kidney Registry, the chain involved 56 participants and resulted in 28 transplants in 19 transplant centers across the U.S., including the Emory Transplant Center (ETC).

According to the National Kidney Registry, this chain illustrates the enormous progress that's been made to shorten set-up times for large swaps, reducing the time patients must wait for a kidney transplant. Large swaps like these also increase the ability to find matches for highly sensitized patients who are very difficult to match.

"Emory began its Kidney Paired Donor Exchange Program in 2010, and we have been participating in the National Kidney Registry since 2012," says Nicole Turgeon, MD, a transplant faculty surgeon of the Department of Surgery of the Emory University School of Medicine and surgical director of Emory's paired donor exchange program. "Paired donor exchange gives patients an opportunity to receive a living donor kidney transplant from a loved one or friend, despite incompatible blood types and positive crossmatches. In paired donation, a donor and recipient are matched with another incompatible donor and recipient pair, and the kidneys are exchanged between the pairs. This was the case with our patients Mr. Poole and Mr. Milford, and the basis of how Chain 221 worked."

For 10 years, Troy Milford, a former pastor who also owns a poultry and cattle farm, had been battling polycystic kidney disease, a genetic disorder characterized by the growth of numerous cysts in the kidneys. He began dialysis in 2009 and was placed on the kidney transplant wait list in 2010. Several of Mr. Milford's family members were tested as potential donors, but were not matches.

After Mr. Milford's friend and former parishioner Robert Poole tested and learned he also wasn’t a match, he learned about the Kidney Paired Donor Exchange Program at Emory University Hospital and registered as a donor. On April 30, both Mr. Milford and Mr. Poole had surgery at Emory University Hospital as part of Chain 221. Dr. Turgeon transplanted Mr. Milford's new kidney, while Dr. Paul Tso removed Mr. Poole's kidney, which was donated to another person half way across the country. Both men are doing well after their surgeries.

"Words can't say how it made me feel that Robert, who's not even related to me, would do this for me," says Mr. Milford. "I am one of 28 people who has a new kidney and a new outlook on life, thanks to this swap. That's what God can do. He can work miracles."

"Troy is a good friend and special person," says Mr. Poole. "He was too proud to ask for help, even when he was sick, so I am really happy I could assist."

"Emory is excited to be a part of the second largest kidney swap in history," says Dr. Turgeon. "Mr. Poole and Mr. Milford had two previous offers in chains that were cancelled. We are happy this swap went to successful completion with 28 people donating kidneys and 28 people receiving kidney transplants."

According to Dr. Turgeon, there are currently over 100,000 people on the kidney transplant waiting list. The discrepancy between the number of organs available and the number of people on the waiting list continues to grow. "Ultimately we want to bring awareness to living and deceased donation with this story," she explains.

Since the Kidney Paired Donor Exchange Program began at Emory, surgeons of the division of transplantation of the Emory Department of Surgery have performed 27 paired exchange kidney transplants as part of the ETC.

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