"Triple-Switch" Kidney Exchange Makes History at Johns Hopkins

In the most complex kidney exchange to date, doctors at Johns Hopkins Hospital this week took kidneys from three living donors with partners who were not a match, and transplanted them into a member of a different pair who was a perfect match.

The "triple-switch," lasting from 7 a.m. to 6 p.m., involved three dozen surgeons, anesthesiologists and nurses in six operating rooms, plus transplant coordinators who moved among the rooms with "coolers of kidneys and words of cheer."

The exchanges were scheduled so that all three pairs moved forward together -- in part so there could be no chance of anyone backing out.

"Logistically, this was monumental." said Dr. Robert A. Montgomery, who led the transplant team. "We were all truly amazed that it worked out."

This complex transaction began when the pairs approached Hopkins' Incompatible Kidney Transplant Program. Each twosome consisted of a person who needed a kidney and someone willing to be a donor. But a simple transplant from one to the other would not work because of blood and tissue compatibility problems.

Johns Hopkins was one of the first transplant centers in the country to perform paired kidney exchanges, in which a person who is incompatible as a donor for a relative or friend gives a kidney to a stranger, and that person's donor reciprocates.

Since 2001, Johns Hopkins has performed four paired kidney exchanges this way, but this was the first time it took three couples to get everyone matched perfectly.

How did it work.

The three pairs were Jeremy Weiser-Warschoff and Julia Tower from suburban Washington, DC, sisters Connie Dick and Tracy Stahl from Pennsylvania, and Germaine Allum and her fiance, Paul Boissiere, from Florida.

Tracy Stahl, 39, got her new kidney from Julia Tower. Julia's family friend, 13-year-old Jeremy Weiser-Warschoff, in turn got a kidney from Paul Boissiere. Meanwhile, Paul's fiancee, Germaine Allum, 30, got a kidney from Connie Dick, Tracy Stahl's sister.

The hospital kept donors' identities secret from recipients - and vice versa -- until several days after the transplant. With everyone seemingly on the road to recovery, all six agreed to waive their anonymity and held a joint news conference to discuss the extraordinary exchange..

Other Sources: Johns Hopkins