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Stony Brook’s 3-state kidney swap a 1st for LI, doctor says

Long Island's first three-state kidney swap took place at Stony Brook University Hospital on March 15, 2016, after an exchange that involved coordinated surgeries, couriers and crisscrossing flights. Doctors involved discussed the challenge on March 17, 2016, at the hospital. (Credit: Newsday / John Paraskevas)

An East Islip couple and the kidney transplant team at Stony Brook University Hospital have participated in Long Island’s first multi-medical center kidney swap, an exchange that involved coordinated surgeries, couriers and jet flights crisscrossing three states.

“This is the first time we have done this and it is a first for Long Island,” said Dr. Frank Darras, lead transplant surgeon, who hand-carried the packed-and-ready-to-ship kidney Tuesday afternoon to a waiting courier. That transporter then rushed the organ to a flight leaving Long Island MacArthur Airport for St. Louis. Darras had just removed the kidney from East Islip resident Tom Danz, 59.

Danz had hoped to donate the kidney to his wife, Angela, 57, who was in need of a transplant after a battle with kidney cancer. Earlier tests had revealed his organ was not a match because his wife’s antibodies would have rejected his kidney.

But the swap across time zones and state lines involving three donors and three patients, including Tom and Angela Danz, allowed everyone in need of an organ to receive one.

One donor-patient pair was at Barnes-Jewish Hospital in St. Louis; the other pair was at an undisclosed Minnesota medical center.

Tom and Angela Danz remained hospitalized at Stony Brook University Hospital on Thursday, both still too groggy to speak. Transplant nurse coordinator Dawn Francisquini reported them to be in excellent condition, and said the kidney Angela Danz received was functioning perfectly.

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Francisquini said Stony Brook is a participant in the organ-exchange program overseen by the United Network for Organ Sharing, UNOS, the nonprofit that coordinates organ transplant activities nationwide.

The organization maintains an active database to help arrange transplants in multiple states when willing donors, such as Tom Danz, prove not to be a biological match with an intended recipient.

UNOS identified a male donor in Minnesota whose kidney matched Angela Danz’s biological specifications and the organization found a male patient in Missouri whose tests revealed a match with Tom Danz’s donor kidney. The kidney of a female Missouri donor biologically matched a female patient in Minnesota.

“We coordinated all of these surgeries at the same time,” Darras said of the three-state ordeal, which involved timing kidney removals, jet flights and transplants.

Although the multistate swap was a first for Long Island, they have been occurring for years among transplant centers nationwide. Outside of Stony Brook, Northwell Health System is the only other center on Long Island offering kidney transplants.

UNOS spokeswoman Anne Paschke said it has become standard practice to synchronize each event in a swap to occur at the same time. That way, everyone who agreed to participate in the exchange gives and receives a kidney simultaneously.

“Sometimes the organs cross in the air,” Paschke said Thursday, noting that a three-state exchange may on first blush seem like a large swap, but her organization has helped coordinate so-called “swap chains.” In addition to UNOS, the National Kidney Registry also arranges multi-center kidney exchanges.

One swap chain five years ago involving Mount Sinai Hospital in Manhattan included 11 transplant institutions and more than 20 donor-patient pairs.

“This adds to the total number of people we are able to help,” Paschke noted, “but the gap still widens as the demand grows.”

She said 22 kidney patients die each day because they have not received a healthy organ. Of the 121,432 people waiting for organs of all kinds, 100,445 need kidneys, Paschke said.

In 2015, 31.5 percent of kidneys transplanted nationwide came from living donors. In more concrete figures, 17,878 kidney transplants were performed, 5,628 involving living donors. Of those living donors, 570 involved unrelated people in paired donations.

Darras, meanwhile, sees multistate exchanges as adding a new dimension for kidney failure patients on Long Island.

He performed the operations on both Danzes in a round-the-clock surgical marathon that began before 8 a.m. Tuesday with the removal of Tom Danz’s kidney and ended at 11 p.m. that day with the completion of the transplant. He said he saw the kidney already producing urine as he finished suturing it in place.

“We are thrilled that we were able to do this,” Darras said, “because it allows us to offer our patients every possible option.”

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