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By Cindy V. Culp Tribune-Herald staff writer
Monday, July 27, 2009
When Mitzi Crum’s mother needed a new kidney, Crum was more than eager to give one to her. Problem was, she wasn’t a good match.
In years past, Crum’s mother, Wanda Irwin, of Waco, would have been flat out of luck. She didn’t have any other loved ones who could donate, and she was too old to get a spot on the national kidney waiting list.
But thanks to a relatively new concept in organ donation, Irwin was able to get a new kidney six weeks ago. Called paired donation, it works like this: The loved one of a person needing a kidney agrees to donate to a stranger, in exchange for someone close to that person donating a kidney back to the person in need.
In this case, it was actually a triple organ swap. The kidney Crum donated went to a 43-year-old woman. A loved one of that woman gave a kidney to a third patient, who in turn provided a kidney for Irwin through a loved one. In sum, six people participated — three as donors and three as recipients.
“At first, when I heard about (donor swapping), I wasn’t open to the idea,” said Crum, 44, a teacher at Hallsburg Elementary School. “It wasn’t what I had been planning. But after I thought about it, I realized it doesn’t matter how she gets it, as long as she gets it.”
Irwin, who is 80, said she is grateful the swap method is now available. She had her first kidney transplant in 1999, after arthritis medication damaged the organ. That kidney came from a deceased person through the national list maintained by the United Network for Organ Sharing.
The transplant lasted nearly a decade. But by February of last year, the kidney had deteriorated to the point where Irwin needed dialysis three times per week. Because of her age, she was not eligible to get back on the national list, she said, making a live donor her only option.
Initial testing indicated Crum was a match, and the two women scheduled a November surgery date. But a few days before the surgery was to take place, further tests revealed an antibody mismatch that would have caused Irwin’s body to reject her daughter’s kidney, they said.
Luckily, the two women said, the surgeon who was supposed to perform the transplant told them about paired donation. Once they agreed to the idea, information about them was entered into a database that contains information about other mismatched donor-recipient pairs.
A computer eventually used that data to figure out the three-way swap. Irwin said she is the oldest person to have participated in an organ swap performed at the Texas Transplant Institute, which is part of the Methodist Healthcare system in San Antonio. In all, the hospital has facilitated eight double kidney swaps and four other triple exchanges, she said.
Crum did not incur any costs as a donor, she said. As is typical for kidney swaps, all costs were paid by the recipient’s insurance company, she said.
“I was in a lot of pain for a couple days, but I’d do it again in a heartbeat,” Crum said. “It was so worth it.”
A group called the Alliance for Paired Donation maintains a national database of mismatched pairs who want to participate in a swap. The group works with 73 transplant centers in 25 states, according to its Web site. The closest one is Scott & White Hospital in Temple.
The San Antonio hospital is not a member of the alliance, however. It instead has its own database, which includes people from several states. Some other hospitals nationwide use similar regional databases.
Irwin and Crum said they are now on a mission to spread the word about organ swapping. Irwin’s transplant should last at least 10 years, she said, giving her a chance to see her four grandchildren grow up.
“If it can help even one family, that’s what it’s all about,” Irwin said.
Michelle Segovia, a spokeswoman for the Texas Organ Sharing Alliance, which facilitates traditional organ donation in McLennan County, said the concept of organ swapping is a great one. Not only does it help people with a willing loved one get a transplant sooner, she said, but it also helps those without such a loved one by lessening the number of people on the national waiting list.
About 102,000 people in the U.S. are on the waiting list for organs, Segovia said. About 80,000 of them need a kidney, with the average wait being four to six years, she said.
“We think it’s great,” Segovia said of organ swapping. “It’s people helping each other.”
cculp@wacotrib.com