Walter Reed participates in kidney swap

[okarol]

Walter Reed participates in kidney swap
   
Keywords, Kidney, swap, transplant, living donor, Walter Reed, National Kidney Registry

By Sharon Renee Taylor

Stripe Staff Writer

Surgeons from Walter Reed Army Medical Center (WRAMC) participated in the first-ever transplant involved in a kidney swap chain for a U.S. military treatment facility, Wednesday.

The landmark, living-donor surgery was the last in a series of inter-connected kidney transplant surgeries at hospitals within the National Capital Region that began on Nov. 5 involving Walter Reed and three civilian hospitals: Georgetown University Hospital and Washington Hospital Center, both in Washington, D.C., and Inova Fairfax Hospital in Virginia.

Two Walter Reed patients, more than 24 others at the participating civilian hospitals, along with a host of medical professionals, from surgeons and pharmacists to immunogeneticists and nephrologists, took part in the series of transplants. The Nov. 17 history-making surgery at Walter Reed means greater opportunity for military transplant patients.

“I think this represents a close collaboration with the community, integrating all of the health medical centers, cooperating together for the benefit of our recipients,” said Lt. Col. (Dr.) Edward Falta, chief of the Walter Reed Organ Transplant Service.

Military transplant patients can join both the transplant list at Walter Reed and another at their local civilian hospital. “It’s like two lottery tickets instead of one,” Falta said.

He called the WRAMC Transplant Service the “center of gravity” for patients who may move to another area, or have a permanent change of station but remain on the WRAMC list, regardless.

Wednesday, Falta transplanted a kidney from a donor at Washington Hospital Center into Walter Reed patient Joseph Pinkowski, 46, a retired Marine gunnery sergeant. Earlier the same day, a Walter Reed urologist recovered a kidney from Pinkowski’s wife Yolanda, 48, for transplant in a patient at Georgetown University Hospital.

Diagnosed with renal insufficiency in 1996, Walter Reed doctors placed Pinkowski on a transplant list more than a year ago. As his kidney function continued to decline to less than 13 percent, he faced dialysis waiting for a donor.

Pinkowski’s options seemed slim when his wife was unable to donate a kidney to him, so the Walter Reed staff went to work to find an alternative — a collaborative effort with civilian hospitals to link transplant patients with compatible living donors at health care facilities within in the National Capital Region. The Alexandria, Va., couple joined more than two dozen patients participating in a complex kidney swap chain.

In a kidney swap, a transplant patient with a willing donor, unable to share their kidney with the patient because of incompatibility with the immune system, is paired with another incompatible patient-donor pair, swapping donors so each transplant patient can receive a compatible kidney. As the number of participants increase, forming a kidney chain, the greater the opportunity to help more patients.

“The concept of doing kidney paired exchange (KPD), also called a daisy chain, was developed and pioneered at Johns Hopkins Hospital, where they performed one of the first KPD transplants in 2001,” explained Dr. Nancy Dipatuan, living donor coordinator for the Organ Transplant Service at Walter Reid Army Medical Center.

Joe and Yolanda Pinkowski speak with Col. (Dr.) G. Bennett Stackhouse, her doctor, prior surgery Wednesday.

Multi-hospital, transcontinental kidney swaps followed. Georgetown University Hospital orchestrated a 14-pair chain in June. Reports indicate the world’s largest kidney swap involved 16 patients in multiple medical centers across the United States.

“When you do a single family [to single] family [transplant], you only get two kidney transplants out of that, but when you have a group, you can have it multiple ways and benefit a lot more families,” Falta explained. “It becomes more of a mathematical solution.”

Walter Reed Army Medical Center is the only U.S. military treatment facility that performs organ transplants, averaging nine kidney transplants a year. More than a hundred patients currently wait on the hospital’s transplant list for a kidney. National statistics report more than 87,000 candidates are waiting for a kidney. For some, dialysis is the only option as they wait.

Studies show dialysis is an expensive life-saving procedure shown to decrease a patient’s lifespan five to eight years, Falta said. He explained the quality of life difference between a kidney transplant and dialysis.

“God gave you a kidney that works instantaneously,” he said. “People are usually exhausted after dialysis.” Falta explained that with dialysis, “Your life is more peaks and valleys as opposed to the steady state you get with your natural kidneys.”

Prior to the transplant, Falta said Pinkowski took more than 10 different medications each day. Over the course of the next year, the number should reduce significantly.

Although doctors expect to release his wife from the hospital in a few days, Pinkowski will remain at Walter Reed a little longer. Falta said patient education is a very important part of the transplant program at Walter Reed.

Pinkowski and his wife will join other donors and recipients involved in the chain, slated to meet for the first time in-person, at a press conference at Georgetown University Hospital Wednesday.

   11/19/2010 
http://www.wramc.amedd.army.mil/NewsAndEvents/media/resource/Lists/wrarticles/DispForm.aspx?Id=714&