It took 12 surgeons, six operating rooms and five donors to pull it off, but five desperate strangers, including a Bangor woman, simultaneously received new organs in what hospital officials Monday described as the first-ever quintuple kidney transplant.
All five recipients – three men and two women – were doing fine, as were the five organ donors, all women, said Eric Vohr, a spokesman at the Johns Hopkins Comprehensive Transplant Center in Baltimore. The 10 participants came from Canada, Maine, Maryland, West Virginia, Florida and California.
Several triple transplants have been done at Johns Hopkins, but hospital officials said the five simultaneous transplants performed on Nov. 14 were a first.
Speaking Monday from her hospital room at the transplant center, Kristine Jantzi, 40, of Bangor, sounded energetic and optimistic. She expects to be discharged within a few days, but will need to stay in the area for about a month so her new kidney function can be monitored.
“But maybe I’ll be home by Christmas,” she said hopefully.
Jantzi said she has suffered from end-stage renal failure most of her adult life. A kidney transplanted at age 20 failed when she was 29. For the past ten years, she’s undergone dialysis several times a week to cleanse her blood of the toxins normally cleared by healthy kidneys. She’s had to maintain a strict, salt-free diet with minimal fluid intake, and all her activities have been scheduled around appointments and medications.
“Your entire life just becomes medicalized,” she said.
Four of the sick patients had approached Johns Hopkins with a relative who was willing to donate a kidney but was an incompatible donor. The fifth patient had been on a waiting list for a kidney from a dead person.
Together, those nine people and an “altruistic donor” – someone willing to give a kidney to anyone who needed it – had enough matched kidneys among them to pull off a complex, five-way swap.
Dr. Robert Montgomery, director of Hopkins’ transplant center and head of the transplant team, pronounced the swap “a demonstration to the rest of the country that this is what’s possible when people work together.”
Assisting the 12 surgeons were 11 anesthesiologists and 18 nurses. The operations took place over 10 hours. The removal of the donor organs began at 7:15 a.m. and was completed by 11 a.m. The kidneys were implanted in operations that began at 1 p.m. and were finished at 5:15 p.m.
Florence Jantzi, 65, of Ontario, Canada, had been eager to donate a kidney to her adoptive daughter, but couldn’t because of Kristine Jantzi’s difficult-to-match blood type.
Kristine Jantzi received a kidney from the altruistic donor, Honore “Honey” Rothstein, 48, of Martinsburg, W.Va. Rothstein decided to donate a kidney after losing her husband to a brain hemorrhage and her daughter to an overdose. She did not know any of the donors or recipients, and the participants in the “domino donor” procedure were not allowed to meet prior to the surgery.
Kristine Jantzi said she and Rothstein met for the first time just before a press conference at the hospital on Monday morning.
“We just looked at each other as we were being wheeled in,” she said. “She has these big brown eyes and the most compassionate face. She’s very healthy; she ran a 5K race just before she checked in.” According to Jantzi, Rothstein told reporters during the press conference that she couldn’t save her own daughter, but she could save someone else’s daughter.
Rothstein was already on her way home to West Virginia by Monday afternoon, but Kristine Jantzi said she expects they’ll stay in touch.
Florence Jantzi’s kidney was donated to George Lonnie Brooks, a 52-year-old semi-retired mechanic from Clermont, Fla. Florence Jantzi was discharged on Monday but will stay in Baltimore to care for her daughter during the coming month.
Kristine Jantzi said she’s eager to return home to Bangor and continue her recovery “to discover what it’s like to be healthy in every way, to not always be a patient with other people directing my life.” She hopes to be able to enjoy “the sensual pleasures of eating and drinking” again. Doctors at Maine Medical Center’s organ transplant program in Portland will follow her progress, she said.
Jantzi plans to advocate for the national program that brought her together with a lifesaving unknown donor. Many people are on waiting lists for organs from deceased donors because they can’t find a compatible living donor, she said, but the match-making technology that allowed the five simultaneous transplants last week opens new doors.
“No one knows about it,” she said. “People need to be informed.”
Annie Moore, a spokeswoman for the United Network for Organ Sharing, the nonprofit organization that coordinates U.S. organ transplants, said the quintuple transplant was the first her organization was aware of. Triple transplants are the most that have been performed to date, and paired transplants are more common, Moore said.
Most kidney transplants use organs taken from cadavers, but doctors prefer organs from live donors because the success rates are higher.
In a live-donor practice used increasingly in the U.S. over the past few years, a patient who needs a kidney is matched up with a compatible stranger if the patient lines up a friend or relative willing to donate an organ to a stranger, too.
About 16,500 kidney transplants were performed in the United States in 2005 with about 10,000 involving organs taken from dead people and 6,500 from living donors, according to the Organ Procurement and Transportation Network.
About 70,000 people are waiting for a kidney transplant in the United States. The wait averages about five years during which 30,000 will either die or become too sick for a transplant, Montgomery said.
Montgomery called for a national kidney-swap program, saying it could help ease the shortage of transplant organs and cut costs by getting people off dialysis. He said 6,000 people on the waiting list for a kidney from a dead person have a willing but incompatible donor.
He noted, however, that live-donor kidney swaps present ethical problems for some institutions since federal law prohibits receiving something of value in exchange for an organ. Some institutions feel multiple arrangements come uncomfortably close to quid pro quo, Montgomery said. He called for a clarification of the law.
More information: Johns Hopkins Medicine: www.hopkinsmedicine.org/ and the United Network for Organ Sharing: www.unos.org
The Associated Press contributed to this report.
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