The Gift of Life Multiplied. (That A-Team Chain Effect)

Cloud 9 is a great place to be, so I figured I would hang out there for a while. This kidney donation process was enlightening, inspiring, humbling, and so much more. I went through the process of being approved, and was finally granted permission. I knew I was going to become a living donor for someone, somewhere. I was entering the program I had heard about for almost a year now; the Paired Exchange within the National Kidney Registry (NKR).

This is where the “A-Team” originated. Back in June of 2016, the social worker I was assigned to with the Transplant Center at UCHealth asked me if I had heard of Paired Exchange? I shook my head curiously ‘no’ and was getting my first introduction to an incredible list/registry/idea that is giving tremendous new hope to people awaiting organ transplants.

Years ago, someone in need of a kidney needed to find a match from friends, loved ones, or an anonymous donor that they found through word of mouth/recruiting. It would be someone to match with them directly. So these willing donors would be tested for a friend or loved one. They were either a match, or not. Maybe blood type wasn’t compatible, or something else wasn’t compatible. That would send them to be listed on the National Registry. Then it would be an altruistic/anonymous match from a living donor, or deceased donor. The registry wait time varies per state, and by blood type. Finding out your life depends on whether you get a kidney transplant has to be stressful enough. To then find out you have a friend who is willing to donate, gets tested, and you can’t use their kidney because your blood types aren’t compatible… I can’t imagine how crushing it would be for both the would-be donor, and even more so, the recipient.

This Paired Exchange program brings more options to people waiting for organ transplants. Think of it the National Kidney Registry as a pool, and attached to the pool is a kiddie pool. The kiddie pool is for people to enter if they have a willing living donor, and are just mismatched for whatever reason. For instance; if your Uncle Nick needs a kidney and his wife Tammy wants to donate, but isn’t a match; they can enter this side kiddie pool. It is a side group of other potential living donors who are mismatched for their friend/loved ones too. The computers are running constantly trying to swap donors to create “matches.”

Let’s use this scenario: Uncle Nick needs a kidney and his wife, Tammy will donate her kidney. Tammy’s blood type isn’t compatible with Nick’s so she can’t directly donate to him. Tammy is still willing to donate to anyone as long as it means that Nick gets a kidney. A match is found in the kiddie pool with Patty, and Samantha. Patty needs a kidney and her friend Samantha is willing to donate, but not a match. Tammy is a match for Patty, and Samantha is a match for Uncle Nick. Tammy and Samantha are altruistic donors because they don’t know the people their kidneys are going to, and in return their loved ones will also receive their transplant.

This is amazing on many levels. It provides an option for these people who have willing donors, yet their blood-types, or other factors aren’t compatible with one another. Maybe they can’t directly donate but they enter this “kiddie pool” in hopes that another donor/recipient mismatch would swap with them and the dream of receiving a new kidney would be granted.

I like to think of it as a game of Memory. Each duo that enters the paired exchange is one donor with one recipient. There is always the 2 in a mismatched situation. Now, instead of only being listed on the National Kidney Registry, and hoping that a kidney comes your way through a random altruist/anonymous donor, or deceased donor you have this other option. Being that you have a willing donor the Paired Exchange will have all these other paired donor/recipients to be flipping over,in hopes that one of them is a match.

Here comes the “chain effect.” If someone is looking to become a living donor, and they don’t have anyone they know that needs a kidney, they have some options. First, the transplant center determines that they are healthy enough to donate. Once cleared, there is the option to go on NKR, and pair with the best one-on-one match there. That is an excellent option. (And the only one I had thought existed when I started testing to be a donor.) Option 2 is to be the start of these chains of transplants that people talk about. This one Good Samaritan Donor (GSD) enters into the Paired Exchange program. The computer goes to work looking for the best match possible between the Good Samaritan Donor (GSD) and all the recipients in that kiddie pool (Paired Exchange).

Let’s relate it to the scenario used before… The Paired Exchange finds the GSD is most compatible with Uncle Nick. Now, this opens up Tammy to be matched with her best match in the (kiddie) pool of pairs. Tammy ends up matching with Patty which opens Patty’s mismatched donor, Samantha, to be paired with a recipient in the pool and so on. In just that situation, 1 person is starting a chain of 3 kidney transplants. The longest chain known to date involved 68 participants (34 donors/34 recipients). That is incredible. The Good Samaritan Donor (that first altruistic donor) always starts these chains. SO, this is why the “gift of life” can be multiplied and I refer to it as the A-Team because we are all in fact, altruistic donors in these chains.

The chain I was fortunate enough to start was 6 people long. It was fascinating to me that kidneys were going to be flown from transplant center to transplant center around the country. Six people were going to get an opportunity to wake up feeling better than they had in a long time. Us living donors would have a short recovery period ahead of us. I haven’t heard from another living donor yet saying if they had they chance again that they wouldn’t do it. There is this surreal feeling of joy that is associated with donating. I have donated my blood, my hair, my time, and money. All of these endeavors have provided much joy, and fulfillment in my life. This kidney donation though is off the charts. I can’t say it was a totally selfless thing to do because the amount of whole-hearted, pure happiness I have experienced from this event in my life is immeasurable. I can’t compare it to anything because I have never felt as ‘at peace’ with a decision from the beginning to the end, knowing that it was 110% the right thing to do. There was absolutely no fear with my decision, no fear with the operation, and absolutely NO REGRETS. I am in the same boat with all the other many living donors before me… Without a doubt… Hands Down… I would do it again! It literally was the opportunity of a lifetime! Every time I look at that scar on my belly; I smile because I know there are 11 other people smiling with me (6 recipients/5 other donors).

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