Team performs Calgary’s first domino kidney transplant
July 29, 2010
CALGARY – In a medical first for Calgary, a Foothills Medical Centre surgical transplant team participated in a national ‘domino’ kidney transplant, which involved eight co-ordinated surgeries at hospitals in three provinces.
“The surgeries were a tremendous success,” says Alberta Health Services surgeon Dr. Mauricio Monroy-Cuadros, who performed the city’s first domino kidney transplant.
“Both the donor and the recipient recovered well, without any surgical or medical complications, and were discharged from the hospital within a week.”
Domino and paired exchange transplants are a possibility for individuals who wish to donate a kidney to a family member or friend with end-stage renal disease but cannot because the match proves incompatible.
Now these incompatible donor-recipient pairs can be added to the Living Donor Paired Exchange, a national organ and tissue registry developed by Canadian Blood Services and piloted in 2009 with transplant programs in Alberta, British Columbia and Ontario. All provinces, except Quebec, are now participating in the registry.
Every quarter, Canadian Blood Services run a match search in the registry to identify potential two-way, paired exchanges (between two incompatible pairs) or domino transplants involving multiple pairs. Proposed matches are reviewed by an advisory board and, if all parties consent, arrangements are made for multiple transplant surgeries. These highly co-ordinated kidney transplants usually take place on the same day.
In this case, the Calgary domino transplant involved two donor-recipient pairs in B.C. and a third in Ontario.
A donor from B.C. travelled to Calgary in April where he donated a kidney to a local recipient. At the same time, the Calgary recipient’s partner travelled to Ontario and donated a kidney to a recipient there. (Travel costs for the Calgary donor were covered by the Living Organ and Donor Reimbursement Programs for Albertans, a new program funded by the Government of Alberta and administered by the Kidney Foundation of Canada.) In the end, four Canadians with end-stage renal disease received life-saving kidneys from four strangers on the same day.
Dr. Monroy-Cuadros says the registry provides greater access to a large pool of living donors and improves the health outcomes for patients with end-stage kidney disease.
All donors and recipients in the registry must remain anonymous, even following transplantation.
To date, 107 donor-recipient pairs and 14 individuals have been entered into the registry. So far, 39 Canadians have received a new kidney through the domino transplant model.
“We recognized the opportunities that being a part of the registry provided to increase living donations in southern Alberta,” says Dr. Monroy-Cuadros.
Nearly 3,000 Canadians are on the wait list for a kidney from a deceased person. Live kidney donation is an attractive option, comprising 40 per cent of all transplants in Canada in 2008.
Two other national domino kidney transplants have been performed involving Alberta patients, both in Edmonton.
Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.7 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.
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