September 30, 2010

Paired kidney exchange links donors, recipients

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Taking part in the paired kidney exchange at Vanderbilt were, from left, Amy Ragsdale (recipient), Terry Green (donor), Courtney Mobley (donor) and Brenda Copeland (recipient). (Photo by Susan Urmy)

Paired kidney exchange links donors, recipients

Amy Ragsdale and Brenda Copeland have a lot in common.

Both suffered from polycystic kidney disease, an inherited kidney disorder. Both relied on dialysis for survival, needed kidney transplants and had several folks willing to donate. But neither of them had a compatible match among their donor pool.

Luckily the pair had another thing in common — Vanderbilt University Medical Center.

Coordinators with the Vanderbilt Transplant Center recognized that both patients had exactly what the other patient needed — donors that were blood-type compatible.

Ragsdale, who is B positive, had a pool of potential donors that had A-blood typing while Copeland's donor pool was populated with B-blood types. She needed A's.

“Thankfully, Vanderbilt noticed that there was another family on the waiting list who had the exact opposite scenario as me,” said Ragsdale. “They ran a cross-match and found that we were compatible with the other's donor. We are just so fortunate to have such incredible donors.”

On Sept. 16, both women were successfully transplanted, through a paired kidney exchange.

Murfreesboro resident Ragsdale, 29, had hoped to receive a kidney from her sister-in-law Courtney Mobley, while Alabama resident Copeland, 64, was to receive longtime friend Terry Green's kidney.

But instead, donors and recipients were swapped. And in the end, everyone accomplished what they set out to do.

“This was the easiest type of swap,” said David Shaffer, M.D., professor of Surgery. “Logistically, it is easier if we can find a swap within our own center. That way patients don't have to travel, nor do we have to ship organs to another center. Everyone is in one place.

“Although swaps are challenging, they are a way to increase living donor transplants,” said Shaffer, surgical director of the kidney/pancreas transplant program. “We will be able to improve patient outcomes and reduce the need for patients to be placed on long waiting lists for a deceased donor transplant. This gives patients the best possible kidney in the shortest possible time.”

This is Copeland's second transplant. First diagnosed with kidney disease at age 27, she received her first kidney in 2005. She has been on dialysis for two months awaiting another transplant.

“Anyone who has been on dialysis knows your quality of life is not good,” said Copeland. “It's just a way to exist. This transplant, although not a cure for my disease, will give me my life back.

“I've been so sick that I spend most of my time in the house. I am so looking forward to getting out more. This is a perfect time to start a walking program, don't you think?”

Ragsdale, who had both kidneys removed over the summer, has lived with polycystic kidney disease since she was 12. She said she can barely remember what feeling healthy is like.

“It has been such a struggle and battle for me,” said Ragsdale. “There are just so many things I am looking forward to. The doctor said I will feel better than I have felt since I was a teenager. For the rest of my foreseeable future I will have a sense of normalcy.”

Donor coordinator for living donor transplants, Verna Johnson, R.N., is pleased the transplants went well.

“There are so many obstacles that can arise when finding compatible organs,” said Johnson. “It's not as simple as finding matching blood types. There's a lot more testing that goes on. But it really all comes down to patience and time to find those perfect donors.”

All patients were discharged and will continue to be followed on an outpatient basis.