Kidney Quest – Kidneys In The News

Gigantic organ swap helps county patients enjoy healthier holidays
by Jeanette Der Bedrosian | Staff Writer

Jonathan Harris, 22, of Silver Spring went under the knife last month to receive the gift of life: a new kidney. Harris was one of 32, including eight from Montgomery County, to participate in one of the world’s largest-ever kidney exchanges.

Dialysis was like a second job for Kiran Kochhar, a Colesville resident who had lost one kidney and damaged his other due to chemotherapy for leukemia.

Kochhar, who works full time as an engineer, traveled two hours each way to get to Washington Hospital Center, and that’s not including the four hours he spent three days a week on the dialysis machine itself.

Kochhar has type O blood, and finding a match was difficult. His wife was willing to donate her own kidney, but the couple’s kidneys weren’t compatible. Last month, a new trend in kidney transplants gave him hope.

Kochhar was among 16 donor-patient pairs to participate in one of the world’s largest-ever kidney exchanges. Like Kochhar, many kidney disease patients have no matching family donors and face a long wait on the kidney donor list, so a doctor at Georgetown University Hospital got creative with patients who had family members or friends willing to donate on their behalf. The process goes something like this: If a mother and son are not a match for a kidney donation, there may be another pairing that has the same problem, and the two groups could potentially swap donors.

That’s exactly what Dr. Keith Melancon did on a larger scale in November for the 16 donor-patient pairs. Five of the patients and three of the donors were from Montgomery County.

Kochhar’s wife said the swap ended a painful waiting game for her and her kidney-needing husband.

“You just kind of wait and wait, and you’re always ready to hear there is a kidney available,” Medha Kochhar said. “But it didn’t happen. You have to match on everything. You don’t know if it will go through or not, so you keep your fingers crossed and hope for the best.”

But Kiran Kochhar found a match in Patricia Harris, a 58-year-old Silver Spring mother of 22-year-old Jonathan Harris. In exchange for Patricia Harris giving her kidney to Kiran Kochhar, her son was given one from someone else in the swap. Jonathan Harris had been suffering from renal failure since he was 12 years old and already had one failed transplant. His mom said the swap was a double blessing for her.

“I realize how blessed I am, that my health at 58 years old is such that I could do a tremendous, life-giving thing,” she said. “I started out with one mission, and that was to try and improve the quality of life for my son. As a result, I was able to improve the quality of life for someone else as well.”

Patricia Harris had helped her son with his nightly dialysis for years, a routine she learned to cope with and build around his schooling. When she met Kiran Kochhar and his wife, Medha Kochhar, it was an emotional experience.

“That was huge, because I got to meet him and his wife,” Patricia Harris said. “And his wife—we were the caretakers of dialysis patients—we had a bond, you know what I mean? She just said, ‘Thank you for giving my husband a kidney,’ and I knew what that meant. That was just huge. It’s been a tremendous form of giving, and it’s something I just hope a lot of other people consider.”

“I have a new freedom,” said Kiran Kochhar. “I’m liberated. I was tied to a chair, and now I can travel anywhere.”

Kidney swaps are growing in popularity, because many kidney disease patients have antibodies in their bloodstream as a result of race, pregnancy, previous infections or dialysis, according to Melancon, who is director of kidney and pancreas transplant patients at Georgetown University Hospital and Washington Hospital Center. These antibodies make the patient less likely to find a match. With Washington, D.C., having such a racially mixed population, more patients have the antibodies, and, as a result, a tough time finding a kidney donor match, he said.

In this round of swaps, 10 of the 16 patients would be considered a racial minority, according to Marianne Worley, the director of media relations with Georgetown University Hospital.

“We are trying to address the group of people who, number one, have the highest rate of kidney disease, and number two, who have the hardest time getting a kidney transplant,” Melancon said.

Melancon keeps a list of patients in need of a kidney that includes their blood types and the antibodies they have. A computer program goes in and fits the pieces of the puzzle together to create as many matches as possible. A technique called plasmaphoresis helps remove some of the antibodies in preparation for surgery.

Similar swaps were organized by Melancon in January, July and December 2009 as well as in June 2010. Each consecutive swap has grown in size, leading up to this one, which was done at roughly the same time as another unrelated 16-way exchange in Texas.

Such a large undertaking is no easy feat for Melancon or the staff of the hospitals that helped out, but seeing the patients meet their donors makes it worth it, he said.

“This takes an incredible amount of work from the nurses and the coordinators,” he said. “It’s an incredible amount of work above and beyond what they normally have to do, and they get to see the fruits of their labor. When they see the big picture of all this coming together—the raw emotion of it all—the message comes home. It’s really my favorite part of the process.”