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The Science Behind a Crazy 6-Way Kidney Exchange | WIRED


IN A SURGERY worthy of the most convoluted Grey’s Anatomy plot, surgeons at California Pacific Medical Center in San Francisco completed a two-day, six-way kidney transplant late last week. Five surgeons and dozens of anesthesiologists and nurses daisy-chained 12 patients together in the West Coast’s largest paired transplant ever.

Patients who need a new kidney are often subjugated to years-long waiting lists, biding their time until an organ becomes available, typically from a recently deceased donor. But living transplants, from donors who give a kidney to a relative or friend, are far more likely to succeed—and can last twice as long before another transplant is needed. The problem is, that selfless donor’s kidney might not be a solid match for its intended recipient. That’s why transplant centers are increasingly working to build chains of donors and recipients: Pairing those who would have donated to a friend with a stranger, so everybody gets the kidney that’s right for them. And with more than 100,000 people on the kidney waiting list, a chain of paired donations can have a far greater impact on that backlog than a single, closed-loop swap would.

On Friday, surgeons successfully completed a six-way paired kidney exchange at California Pacific Medical Center. Sutter Health/California Pacific Medical Center

Today, about a third of the 16,000 annual kidney transplants come from living donors, a number that keeps rising through paired procedures. Getting six people to donate their kidney to a complete stranger is a remarkable feat of altruism. But it’s also a testament to biomedical technology: The testing and treatments that make kidney transplants so successful, and the algorithms doctors and patients use to find the right match—or, in this case, six matches.

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