(Jan. 3, 2014)
A four-person kidney transplant has given two people hope in the new year and two more the satisfaction of knowing they helped save a life.
Physicians from the Brody School of Medicine at East Carolina University and a local private practice participated in the transplants, which took place Dec. 16 at Vidant Medical Center.
Dr. Robert Harland, professor and chief of surgical immunology and transplantation at ECU and chief of transplant surgery at VMC, said the procedures were successful and allowed two of the hospital's wait list patients to receive living donor kidneys instead of potentially waiting years for a kidney from a deceased donor.
"This is the culmination of a process that has taken several months," Harland said. "Each of these recipients had a willing donor who was not compatible with them. By finding better matches from our list of incompatible donors, we were able to successfully perform two living donor transplants, which can be performed electively and have a longer lifespan than a transplant from a deceased donor."
Jamal Peele of Greenville and Leslie Smith of Bevinsville, Ky., each had planned to donate one of their healthy kidneys to relatives, but were not good matches. They were good matches, however, for each other's relatives.
Thus, Peele donated to Smith's aunt, Sherrie Hoopes of Jacksonville. Smith donated to Peele's mother, Brenda Peele of Greenville.
In these transplants, the two recipients who needed a kidney had antibodies that reacted with their intended donors' tissue types, predicting a much higher risk of rejection. However, by exchanging kidneys, recipients could avoid these incompatibilities and receive a kidney transplant with a more successful outcome.
The donors met the recipients for the first time Monday, Dec. 30, and all are doing well. Both donors underwent their procedures laparoscopically, which requires smaller incisions. The donors were discharged from the hospital in two days and typically experience a quicker recovery than traditional kidney donation surgery.
The recipients are off dialysis and have normal kidney function. They were discharged at three and four days after surgery, the usual length of stay.
Before her transplant, Brenda Peele said, she felt tired all the time. "When I woke up (after the surgery), I felt better than I had in years," she said.
In addition to Harland, the following experts were involved in the procedure:
--Dr. Claire Morgan (ECU Physicians)
--Dr. Carl Haisch (ECU Physicians)
--Dr. Reginald Obi (ECU Physicians)
--Dr. Heather Jones (Eastern Nephrology Associates)
--Dr. Kristel McLawhorn (Eastern Nephrology Associates)
--Dr. Scott Kendrick (Eastern Nephrology Associates)
--Dr. Lorita Rebellato (ECU associate professor of pathology and laboratory medicine director of histocompatibility lab)
This kidney exchange was the second performed by the transplant program at ECU and VMC, following a six-person exchange in 2011
. Harland estimates that about 500 paired exchange kidney transplants were performed in the United States in 2013, representing fewer than 10 percent of the approximately 6,000 living donor kidney transplants performed. However, this transplant option has seen rapid growth over the past five years. The first paired kidney exchanges were performed in the United States in 2000.
In addition to maintaining an internal paired exchange list, patients listed at VMC have available the option of being listed for a nationwide exchange list, further increasing the option for patients with an incompatible donor who are awaiting kidney transplantation.
More than 434 eastern North Carolinians are awaiting a kidney transplant at VMC, according to according to Jennifer Thompson, transplant coordinator with Vidant Health. In 2013, doctors performed 94 kidney transplants, up from 88 in 2012.
The typical length of time between joining the Vidant/ECU waiting list and receiving a transplant is between 36 and 60 months, Thompson said.
Thompson estimated more than 3,000 people are on dialysis in the 29-county area served by Vidant Health.
Brenda Peele summed up the feelings of the family members attending the press event when she said: "It's just amazing. They matched us and we don't even live in the same state."
For more information about kidney transplants at ECU and VMC, call 252-744-2620.