Hospitals to partner for paired kidney exchange

ST. LOUIS -- Prestigious hospitals in St. Louis and Baltimore are teaming up to expand the relatively new practice of kidney swapping, and in the process create a national blueprint for long-distance transplants.

For months now, Barnes-Jewish Hospital in St. Louis and Johns Hopkins Hospital in Baltimore have been comparing and analyzing each other's lists of people who need kidneys and those who have offered to give them one, but whose blood type or tissue are incompatible.

The hope is to match pairs of willing donors and sick people needing the donation.

The institutions, with their large patient base, say they've identified some potential pairs that could be matched.

"We're pretty close, but I can't say when it will happen," said Dr. Robert Montgomery, director of Johns Hopkins' Comprehensive Transplant Center.

Paired kidney exchange was described in the 1980s, but logistical challenges kept it from being practiced until 2000. Since then, more than 220 exchanges have happened around the U.S., mostly between hospitals in the same city or region. Johns Hopkins alone has done 50 of them -- more than any other U.S. hospital.

Earlier this year, Montgomery choreographed a kidney swap involving three pairs of donor/recipients in Maryland and California. The Baltimore hospital also did the first five-way kidney swap last fall.

The partnership between the St. Louis and Baltimore medical centers -- 840 miles apart -- could build momentum toward a national program, making it commonplace to do long-distance transplants from matches found outside a region, he said.

The goal is to make a national registry of incompatible kidney donors, dramatically increasing the likelihood of a match.

If realized at the national level, it would be the single biggest expansion of live kidney donation in its history, Montgomery said.

Gene Ridolfi, who directs the solid organ transplant center at Barnes-Jewish and Washington University School of Medicine, said the institutions have designed the process, shared information and identified potential matches.

If one of them turns out to be a true match, the exchange could happen within a month or so.

Some believe that such swaps violate a federal ban on organ sales. But the U.S. Department of Justice has said it doesn't, and Congress is expected to pass legislation stating the exchanges are legal.