Date Published: 27 February 2009

Domino Kidney Donations Key to Reduced Waiting List

A team of transplant physicians and surgeons in Perth, led by Professor Paolo Ferrari, has successfully performed the first ‘domino paired kidney transplants’ in Australia, giving three Western Australians suffering from kidney failure a new lease on life.

The surgery became possible when an anonymous ‘altruistic’ donor donated a kidney for transplant to any suitable ‘stranger’ on the kidney transplant waiting list.

Director of the WA Kidney Exchange Program Professor Paolo Ferrari, who coordinated the complex series of transplants with the surgical team of Professor Luc Delriviere, said it was a ground breaking achievement that would pave the way for similar procedures throughout Australia.

“Rather than matching the altruistic donor with the next compatible patient on the National Organ Matching System waiting list, which would have enabled one transplant, the Perth team matched the altruistic donor with a string of kidney patients who had a willing but incompatible living donor already enrolled in the kidney exchange program, “ he said.

“This single act of altruism set off a domino effect that resulted in three kidney transplants, performed at Sir Charles Gairdner Hospital.

The three donors had one of their healthy kidneys removed using advanced keyhole surgery techniques.

All three transplanted kidneys are working, with the donors and recipients all doing well.”

The domino paired donations method of organ allocation was originally developed by a team at Johns Hopkins Hospital in Baltimore, USA and was first reported in 2006.

Professor Ferrari said this method would help address the shortage of donor kidneys in WA and Australia.

“Domino transplants are an exciting new strategy to tackle the shortage of donor kidneys for patients needing transplants,” he said.

If we can facilitate an exchange of knowledge with other surgeons in hospitals throughout Australia, we can start undertaking more of these procedures and hopefully ease the burden on transplant waiting lists.

At the moment this type of procedure is fairly new so we’re really on the cutting edge when it comes to paired kidney donation.

Our aim is that with more donors and new techniques, we can help more people receive the organs they need with a minimum of waiting time.”

It is expected a national paired kidney exchange program, to maximise available organs from live donation, will be established in 2009.

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