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Two-Way Kidney Swap with Complicated Blood Incompatibility Performed for First Time in DC Area


January 9, 2009

Patients Who Had 'Given Up' on Transplant Receive Life-Saving New Year's Gift

For the first time in the DC-area four people have come together so that two patients could receive life-saving kidneys in a two-way transplant swap involving one recipient who had been deemed "incompatible" for a transplant.

David Wilson (recipient) and Darren Curtis (donor) meet for the first time
David Wilson (recipient) and Darren Curtis (donor) meet for the first time after their transplant surgery.

The transplant took place on January 6th with the parties not knowing who had donated or to whom they were donating. The four patients, including a married couple, met for the first time four days later.

Yasan Wilson (donor) and Tanita Simmons (recipient) embrace after an emotional introduction
Yasan Wilson (donor) and Tanita Simmons (recipient) embrace after an emotional introduction.

39 year-old David Wilson of Reston, Virginia had given up on ever getting a transplant because his blood was highly sensitized to human antibodies (human leukocyte antigens or HLA's), making the chances of rejecting a new kidney too high to attempt a transplant. His wife Yasan Wilson was willing to be his donor but their blood was highly incompatible due to a blood transfusion Mr. Wilson received after his first kidney transplant, which rejected after five years in 2004.

On the other side of town in Washington, DC, 31 year-old Tanita Simmons was in end stage kidney failure and in desperate need of a kidney transplant in order to survive. Her former boyfriend Darren Curtis was willing to be her donor, but they too were incompatible due to human leukocyte antigens in Ms. Simmons's blood. So physicians and transplant coordinators at Georgetown University Hospital began testing the two in need of transplant and their two voluntary donors and discovered that Yasan Wilson could donate to Tanita Simmons and that Darren Curtis could be made compatible with David Wilson using a new "blood cleansing" procedure newly available at Georgetown University Hospital.

In order for Mr. Wilson to be able to successfully accept Mr. Curtis's kidney, three nights before the transplant Mr. Wilson underwent the procedure called plasmapheresis at Georgetown under the direction of Keith Melancon, MD.

Dr. Melancon said, "We essentially clean the blood to keep the sensitized recipient from rejecting the donated kidney. In addition to patients with HLA incompatibility, we have used this procedure to transplant donors and recipients with mismatching blood types. This means we will be able to work our way down the waiting list more quickly and for people who thought a kidney transplant wasn't possible, it might now be possible."

Sensitization is caused by blood transfusions, pregnancy, a previous transplant or extended time spent on dialysis. The more antibodies in the blood, the harder it becomes to find a suitable donor whose kidney will not be rejected.

"DC has the highest rate of kidney disease and diabetes in the nation. This is just the beginning for these kinds of transplants here in the city. We know we can use this technique to match donors with recipients whose blood sensitization issues are so severe that they had been deemed unsuitable for transplant," said Dr. Melancon.

The four separate surgeries took place on January 6th and started with Yasan Wilson going into surgery first to have her kidney removed, then transplanted into Tanita Simmons. Then Darren Curtis went into surgery to have his kidney removed, then placed into David Wilson.

Dr. Melancon (Left) removes kidney in 4 patient 2 way transplant.
Dr. Melancon (Left) removes kidney in 4 patient 2 way transplant.

Because the donors needed to remain anonymous to the recipients, the transplants presented unique challenges for GUH nurses, physicians and coordinators. As two of the patients recovered just across the hall from one another, GUH staff had to keep the four from running into each other until they were all well enough and agreed to meet.

"I had pretty much given up on ever having another kidney transplant," said Mr. Wilson. I knew that my blood was so highly sensitized. I figured that my only course in life was dialysis three days a week, four hours a day. Like brushing my teeth or anything else, I figured that was my life. I am so grateful and feel so blessed to have this new chance at life."

Tanita Simmons was first diagnosed with high blood pressure when she was just seven years old. She started dialysis at age 11 and had her first kidney transplant at age 16 in 1993. Her kidney was failing badly and she was also having dialysis three times a week.

"I think this is just awesome that we were able to do these transplants. I too am so grateful to have this second chance at a normal life and I am just so thankful to my donor for making this possible for me and my family," Ms. Simmons said.

Keith Melancon, MD, with part of the transplant team who worked on the kidney exchange.
Keith Melancon, MD, with part of the transplant team who worked on the kidney exchange.

"This kidney exchange sets the stage for us at Georgetown to do more of these types of paired exchanges of possibly more donors and recipients at one time," said Dr. Melancon. "I know there are people on dialysis right now in our area who think they have no hope of a transplant due to HLA sensitization or their donor's blood type is a mismatch. This procedure is now an option many of them can consider and explore."

Media Contact: Marianne Worley
Phone: 703-558-1287
Email: WorleyM@gunet.georgetown.edu

Patient Contact: 202-342-2400



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