Kidney Procedure Illustrates Some Wide-Ranging Possibilities

During a recent cross-country kidney transplantation — a California woman received a kidney from an anonymous, living donor in New York — the operation was the easy part.

The bigger problem for surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, who typically book donors and recipients in adjacent or nearby operating rooms, was that they had to race to retrieve the organ, pack it in ice, and transport the kidney inside a cooler to Newark Liberty International Airport, where it was stowed in a closed-off area of the cargo hold on a Continental Airlines flight to Los Angeles. There, 14 hours after surgery commenced in New York, surgeons at Ronald Reagan UCLA Medical Center completed the transplantation. "This does represent a departure from the standard, but it demonstrates it can really work," the chief of transplantation surgery at NewYork-Presbyterian/Weill Cornell, Dr. Sandip Kapur, said. Hospital officials said they believe the July 30 procedure is one of the first transcontinental kidney transplantations from a living donor. Kidneys are viable for transplantation for between 24 and 36 hours after retrieval.

According to the surgeon in Los Angeles, Dr. Jeffrey Veale, the kidney began working almost immediately. "Once I unclamped it, it started to make urine immediately," Dr. Veale, an assistant professor of urology at the David Geffen School of Medicine at UCLA, said at a joint news conference yesterday with physicians from New York and California.

The transplantation was also part of a new method for linking living organ donors and recipients.

Typically, living donors provide organs to family members; the new method links a donor who does not have a biological match to a family member to someone else seeking a kidney. In exchange, someone close to the recipient — usually a family member — then donates an organ to someone else, thereby creating a "donor chain."

The method is meant to promote kidney transplantations. As of yesterday, there were 76,650 individuals registered on a national waiting list for kidney transplantation that is maintained by the United Network for Organ Sharing. In this case, an anonymous donor in New York started a chain resulting in three transplantations in California. The first donor's kidney went to a woman, Pamela Heckathorn, whose cousin donated a kidney to a patient named Maricela Carvajal. Mrs. Carvajal's husband then donated to a woman named Inocenta Platt. Ms. Platt's son is planning to donate a kidney August 18. Three more links in the donor chain are being planned.