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Six Patients Reunite After Triple Kidney Swap

A three-way kidney swap involving six patients, two hospitals and strategic organization from the New England Organ Bank allowed simultaneous transplants at Beth Israel Deaconess Medical Center and Massachusetts General Hospital on Feb. 27.

Boston- A three-way kidney swap involving six patients, two hospitals and strategic organization from the New England Organ Bank allowed simultaneous transplants at Beth Israel Deaconess Medical Center and Massachusetts General Hospital on Feb. 27.

Three people in need of kidneys were incompatible with their willing donors. With the participation of a "Good Samaritan" donor, the New England Program for Kidney Exchange (NEPKE) matched the six people to make three perfect matches.

"My son was very sick," said Collette Clifford, who wanted to give her son, Ryan, one of her kidneys. Tests determined they were an incompatible match. Rene Ravenelle and his brother, Robert, faced a similar situation when Robert was not a match for Rene. After two prior kidney transplants Chris Santamaria had run out of compatible family donors and was on the transplant waitlist for two years.

That's when Lisa Dubois came into the picture.

Dubois had read a newspaper article about someone in need of a kidney and decided to become a donor. She was not a match for the person in the newspaper story, but Dubois still wanted to be a donor for someone else in need. She became the "Good Samaritan" donor that made this six-person exchange possible.

"It didn't matter who I donated to, just as long as I could help somebody," said Dubois, who was the key factor in the domino effect that allowed the NEPKE system to make a match for Clifford, Ravenelle and Santamaria. The NEPKE computer program identified these cases and matched the donors in these incompatible pairs. Dubois donated to Ryan Clifford at MGH. Ryan's mother, Collette, donated to Rene Ravenelle at BIDMC, and Rene's brother, Robert, donated to Santamaria at MGH.

"With more than 70,000 people on the waiting list for kidney donations across the country, the ability to help three patients by transplanting compatible kidneys from live donors is a major step forward," said Martha Pavlakis, MD, Medical Director of Kidney Transplantation at BIDMC.

With four of the patients being operated on at MGH and two here at BIDMC, the surgeries were no small feat. Scott Johnson, MD, Transplant Surgery, led the team at BIDMC and says the transplants had to begin simultaneously. This is done to ensure fairness and make sure everyone who is supposed to get a transplant receives one.

"It took about three hours to get the kidneys from the donors and another three hours putting the kidneys in the new recipients," Johnson said. A total of 20 staff members from both hospitals were needed to pull off the three-way swap including surgeons, nurses and anesthesiologists.

Almost a month after their successful surgeries, the donors and recipients met for the first time at the New England Organ Bank March 21. Some brought flowers for their donors and others exchanged grateful hugs.

"Kidney donation, quite simply, is an act of heroism. What we have here that's extra special, is that we have people willing to donate to someone they don't know in order to help a loved one," said Pavlakis.

Dubois doesn't see any heroism in what she's done. In fact, she takes every opportunity to play it down. "I'm just an average mom, working person," she said. "I don't see what I did as extraordinary."

But Clifford, who broke down when meeting Dubois for the first time, said, "To me she's just a total angel… she gave life to my son."

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox.