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Altruistic donor chain enhances transplant options

Jan. 23, 2014, 9:13 AM

Kidney transplant patient Travis Beasley, right, and his wife, Collette, talk with Amelia Maiga, M.D., MPH, left, and Deonna Moore, APRN-BC, during a follow-up visit. (photo by Steve Green

Thanks to a series of altruistic donations that began in Colorado, three people who were waiting for a kidney received a life-saving transplant, including a patient at Vanderbilt University Medical Center.

Travis Beasley, 41, was stop No. 3 in the cross-country string of donations and transplantations known as a non-simultaneous extended altruistic donor chain, or NEAD.

The multiple kidney transplants occurred under the careful orchestration of the Alliance for Paired Donation, a coalition of transplant programs that pool patients into a single registry with the aim of increasing opportunities for transplants.

Although complex to coordinate, the NEAD chain is the newest tool in the Vanderbilt Transplant Center’s arsenal to combat excessive waiting lists and to help keep people from dying while waiting for a new organ.

This is how it works:

Many people on the waiting list for a new kidney have a family member or friend who is willing to donate a kidney, but are not compatible with their intended recipient. Instead of completely closing the door on these donors, they are put into a computer program that matches them with others throughout the United States.

“These kinds of donations allow for more people to receive transplants,” said Rachel Forbes, M.D., surgical champion for NEAD for Vanderbilt’s Kidney Transplant Program. “We can reduce the time a person spends on the waiting list and reduce the size of the waiting list by increasing the number of potential donations.

“We want the extended donor chain to be as long as possible so that we can maximize the number of kidneys that can be utilized.”

The largest chain so far has included 60 people; 30 recipients and 30 donors, said Forbes, assistant professor of Surgery. She estimates that the living donor chain can increase the number of kidneys transplanted by 3,000 a year nationally.

With nearly 100,000 people waiting for a kidney, the initiative has the potential to make a sizeable dent in the waiting list.

For Beasley, Vanderbilt’s first NEAD chain recipient, the new program was a perfect match.
The Paris, Tenn., resident has been on the waiting list since 2011. He received his new kidney on Dec. 11, 2013.

“My wife, Collette, really wanted to give me a kidney,” said Beasley. “But she wasn’t a match for me. She had watched me on dialysis all this time and she wanted to do something to help me. She said if she couldn’t give me hers, then she would give it to someone else so that I could receive another one.

“Because she was willing to donate to someone else, I received my kidney and I am doing really, really well. I have so much more energy and feel so much better. I am really looking forward to getting back to work.”

Now recovering from his transplant, Beasley said the couple is anxiously awaiting information about when his wife will undergo surgery to donate her kidney.

“The chain is great,” Beasley said. “It just benefits lots of people. I know my wife is a little nervous, but she is looking forward to helping someone else.”

Currently the chain is still open pending Collette Beasley’s donation, which is connected to the computerized database that lists donors and recipients registered in the United States.

“It takes a lot of planning from the Alliance for Paired Donation,” Forbes said. “It’s not all matching compatible donors and recipients. It also involves a person’s ability to donate as well as flight schedules. I’m thankful that there is a company that handles all of that.”

For now Vanderbilt is looking forward to expanding kidney transplant opportunities for both donors and recipients.

“This is one option that really seems to be working well as more groups and consortiums are utilizing this form of donation,” said Forbes.

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