Johns Hopkins doctors are using a domino-paired scheme to carry out more kidney transplants

Reported by Susan Aldridge, PhD, medical journalist

More patients in need of a kidney transplant can benefit under a new scheme using domino-paired donors.
With increasing rates of kidney disease, the gap between supply and demand for kidney transplant seems set to widen. So it makes sense to make best use of the organs that are available. One trend in recent years has been the use of altruistic organ donation. This involves a living person being willing to donate a kidney. But the problem is that the kidney may not be compatible with the potential recipient. In such cases, the donor may go to the Internet or to local transplant center to find a match - and they are lost to the original recipient.

Doctors at Johns Hopkins University have been working with a domino-paried donation program in an attempt to get round the incompatible altruistic donor issue. Under this scheme, a kidney patient with a willing but incompatible donor gets matched instead with a compatible donor. The incompatible donor then gets matched with the next suitable patient on the United Network of Organ Sharing list - a national system regulating organ donation. In that way, both donors are treated to the same ethical standards and organs are not 'wasted'. Using the domino approach, Johns Hopkins surgeons recently did two triple and one double domino-paired kidney transplant - supplying eight recipients with kidneys. With more conventional approaches, only three kidneys would have been used. The domnino system uses the altruism of potential donors to create maximum benefit to kidney patients.

Source
The Lancet August 2006

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