Best friends Kaaren Johanson and John Foley, two links in the first-ever 16-person kidney donation chain last month at The Johns Hopkins Hospital in Baltimore, said the experience has changed their lives.
And not just because Johanson now has a functioning kidney and Foley is minus one of his.
Now home and recovering well, Johanson and Foley have embarked on a broader mission to spread the word about kidney donation -- particularly among willing pairs like themselves whose organs didn't match well enough for the one-to-one swap they originally envisioned.
"I can't help but think of how many other people are out there who want to make this happen," Johanson said.
And they may be able to. Based on successes such as those at Hopkins, the United Network for Organ Sharing has announced it is beginning a national donor chain program that will initially involve swaps among two- and three-donor pairs.
Elizabeth Sleeman, a policy analyst and liaison to the kidney paired donation work group at UNOS, said the organization hopes to enlist four or five groups of hospitals this summer to help launch the program and begin doing small transplant chains before the end of the year.
By the start of 2011, she said, all hospitals that do kidney transplants as part of UNOS will be able to access the organization's national database to mix and match pairs and create their own donor chains.
"It's certainly an exciting development," Sleeman said, noting that such swaps have the potential to provide an additional 1,000 to 2,000 transplants a year.
Last year, 16,517 people got kidney transplants. But there are 80,149 people in the United States on the kidney donation waiting list, including 2,487 in North Carolina, according to UNOS.
Many of those people have a loved one who is willing to donate a kidney to them but who has incompatible blood or tissue to make a successful transplant.
It's the same situation that Johanson and Foley faced. The two met at the DaVita Dialysis center in Durham where Foley, 52, worked as a technician and Johanson, 46, was his patient. Fast friends, he decided to give her one of his kidneys, but tests showed they were no match.
"I didn't take no for an answer," Foley said.
Instead, the duo discovered the program at Hopkins, where doctors had begun shuffling donor pairs in their database to structure increasingly large and complex transplant chains. Johanson didn't match Foley, but she matched a donor in Detroit. Foley was paired to a recipient in Oklahoma City.
Originally slated to include 12 people, the chain was expanded to involve a total of 16. The marathon string of transplants and organ harvests began June 15 and finished July 6. Foley and Johanson were among the largest group who had operations June 22.
After recovering for several days, Foley returned to his home in Raleigh the following Saturday. He said he has lingering fatigue but otherwise feels well.
Johanson had complications stemming from earlier surgeries -- she now has five kidneys in her abdomen, including her own two that type 1 diabetes ruined, and two previous donations that eventually petered out.
As a result, she spent eight days in the hospital. She's now back in Durham and says she has much more energy with her new kidney.
Johanson says she's eager to put her new kidney to good use, working with Foley to make paired transplants widely available.
"What I have received from this experience far outweighs what I gave," Foley said. "I think this whole thing is just a miracle."
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