IN an incredible medical marathon, a dozen Victorians went under the knife in Australia’s largest live kidney donation and transplant swap.
The Australia-first paired kidney exchange, if successful, will give six people who have been languishing on dialysis a second chance of life.
Twelve operations to remove and transplant the organs were performed in four major hospitals across Melbourne yesterday.
The extraordinary chain of events was triggered by Victoria’s first altruistic donor giving a kidney up to a stranger.
That selfless act set off a domino effect that became the nation’s first six-way paired kidney transplant exchange attempt.
Five other Victorians gave up a kidney to a suitably matched stranger.
A loved one of each donor who was in need of a kidney received a donated organ in return.
The surgical procedure to remove and transplant six kidneys in full swing. Picture: Ellen Smith Source: News Limited
It took months of planning to ensure that all 12 operations could take place across Victoria on a single day.
Entire operating theatre lists were cleared, hospital beds were freed up, and transplant teams organised to perform the back-to-back operations.
Patients went under the knife at the Royal Melbourne Hospital, the Austin Hospital, Melbourne Private and the Monash Medical Centre.
Five couriers raced kidneys across the city.
Not even the closure of the Monash Freeway over a bomb threat could stop the operations.
The miraculous gift of six lives. Source: HeraldSun
The surgeons, transplant co-ordinators, nurses and doctors were cautiously optimistic on Thursday night, after all operations were completed just before 7pm.
But the success of the transplant attempts may not be known for several days.
Royal Melbourne Hospital’s nephrology chief, Professor Steve Holt, said the chain of operations, under the Australian Paired Kidney Exchange program, had been the six patients’ best hope of freeing themselves from a miserable existence on dialysis.
More than 1000 Australians are on the waiting list for a kidney from a deceased donor.
Surgeon Tim Furlong seals a kidney to get ready for transportation. Picture: Jay Town Source: News Limited
The kidney is then sealed in a transport box. Picture: Jay Town Source: News Limited
But Prof Holt said: “These patients were probably not going to get a transplant without this (Kidney Exchange) program, because they are often people who have multiple antibodies.”
Having too many antibodies as a result of pregnancies, previous transplants, or blood transfusions makes organ rejection a real risk.
“So the chances of them getting a kidney match from the standard waiting list is quite low,” Prof Holt said.
“This is their best chance of getting a good kidney, so it’s been a real boon for everybody involved.” he said.
The Royal Melbourne Hospital’s renal transplant co-ordinator, Emma van Hardeveld, said months of work had gone into testing donors’ and recipients’ compatibility, and also liaising with hospitals and surgeons to ensure that they had the beds, operating theatres and staff to perform all the operations.
A donated kidney in a transport box with ice and preservation solution. Picture: Jay Town Source: News Limited
Up to 80 medical staff had been nervously anticipating the big day, which could easily have been undone by a single sickness among the donors or recipients.
“The logistics of such a large procedure, involving six donors and six recipients, is a huge challenge,” Prof Holt said.
If one patient had pulled out or become unwell, all the operations would have been cancelled.
But meticulous planning, teamwork and monitoring have now ensured that the first hurdle has been overcome.
All the patients will remain in hospital until clinicians are satisfied the operations have been a success.
Prof Holt praised the team effort that made the transplant attempt possible.
“It’s a real testament to Victorian hospitals that we can work together to achieve this,” he said.
AND THE ORGANS WERE ALL IN TUNE
ALL donors confirmed asleep.
It was these four words at 8.24am on Thursday morning that started an extraordinary kidney exchange to save the lives of six Victorians.
Moments later five surgeons were poised over the first five anaesthetised patients, ready to make an incision in their abdomens.
Once the scalpel pierced their skin, there was no turning back.
These five people were giving up one of their kidneys to a stranger.
Each donation would allow another to occur, in a domino effect that could save the lives of six people.
A text message is received that all patients are “asleep”. Picture: Jay Town Source: News Limited
If one person pulled out or was unable to donate, the whole chain would be broken.
These five people wanted so desperately to help their loved ones by donating a kidney, but they were not suitable matches. But there was a way.
If their kidney was a match to another pair, who also needed a kidney, but who had an unsuitable but willing donor, they could do an exchange.
By chance, Victoria’s first purely altruistic living donor had also come forward.
Their details were combined with a pool of donor and recipient details and fed into a computer program.
The computer said ‘yes’. It spat out six matches. It meant six people would give a kidney so half a dozen could receive one.
A donor is stitched up. Picture: Jay Town Source: News Limited
The sixth recipient would be someone who, along with more than 1000 other Australians, was on the frustratingly long waiting list.
Yesterday, tensions were high in four of the state’s major hospitals. This had never been attempted before.
Surgeons like The Royal Melbourne Hospital’s surgeon Mr Tim Furlong had skilfully disconnected the kidney from the abdomen, using a long instrument poked through a 1cm hole.
Care was taken to preserve the artery, vein and ureter so it could be used to plumb the organ into the recipient.
The organ is couriered to its new recipient. Picture: Jay Town Source: News Limited
Fat was trimmed from the organ and soon it was ready for its new host. Five kidneys came out.
Five couriers set off, in a race across the city, zigzagging their precious cargo through peak-hour traffic.
The contents of the unassuming boxes were organs swimming in ice and preservation solution.
There were so many kidneys going back and forth the Kidney Transplant co-ordinator at the Royal Melbourne Hospital, Belinda Jones, said they would be not double- but triple-checked.
The kidneys were plumbed with precision into the pelvises of the recipients.
They were gifts of love as much as gifts of life.