"I've done a lot of things that I'm proud of. Being a father and a husband first and foremost, and a professional second, but to save a life, extend a life or impact a life, is something that we don't often get a chance to do," Myrtle Beach Area Chamber of Commerce President, Brad Dean, said.
Dean has never met the woman who received his organ through the paired exchange program. It's called an altruistic donation and it plays a key role in the ability for medical centers to build donor databases, ultimately saving the lives of more patients in need of a kidney.
"The classic paired exchange is two donors and two recipients who are incompatible with each other, and then they cross their organs. The problem that we run into is, as we're running the algorithm in the program, we find good matches but one of the recipients is left out because there's not an organ available for him or her. This is where an altruistic donor comes in because that altruistic donor obviously doesn't have a recipient who needs an organ and so that allows us a little bit of play," Medical Director of Kidney Transplantation at Duke, Dr. Matthew Ellis, said.
Between 80,000 and 90,000 patients are on the waiting list for a kidney transplant in the United States. 15,000 to 20,000 will actually find a match. If a paired exchange program were applied nationwide, similar to the way the deceased donor allocation is done, around 3,000 extra transplants could be completed. In South Carolina alone, 885 people are on the waiting list. Dean decided to participate after a couple of his close friends and a mentor got a second chance at life after receiving organ transplants.
"The demand for kidney transplants is huge. It's the largest among all organ transplants. The chief reason for this is the patients who have kidney failure can be supported artificially by dialysis, so they can be dialyzed for long periods of time. Patients with liver failure, heart failure, lung failure, they do not have the artificial support," Duke Transplant Surgeon, Dr. Kadiyala Ravindra, said.
Recipient Sue Gommer, of Holly Springs, NC underwent dialysis and spent over a year on the waiting list before receiving Dean's kidney Monday. Her daughter Jennifer was her living donor, but their blood groups didn't match. Jennifer was, however, a match with Jeffrey Rogers, of Robeson County, NC. The paired exchange is historic because it's the first time that both the donors and recipients were matched in the state of North Carolina and specifically at one medical center. Dean's altruistic donation was key in itself, but his rare blood type, which is the common game-changer when it comes to organ transplants, was an added bonus.
"Altruistic donors really expand the pool because they eliminate the need for that last recipient and and they also, if they're O, they can start a long chain of donors and recipients. A blood group O organ can go into any blood group patient. That's the universal donor, so that person can really enable a chain reaction of swaps to happen," Dr. Ellis added.
Monday's surgeries put Duke University Medical Center's paired exchange program on the map. The transplant team's six surgeons are seeking to build their database. "Our program is in its infancy and we have a limited number of recipients and donors in our database, but the idea is as we continue to enroll people and create excitement about this, is we'll have more and more people in our database and more likely make matches. If you extrapolate that on a regional or national level, if you're enrolling pairs and in larger programs where there are more people in the database, you're much more likely to find a match," Dr. Ellis said.
Recipients like Gommer and Rogers also benefit from the program because they received an organ from a living donor. Typically, a kidney donated by a living recipient lasts three to five years longer than that of a deceased donor. "The beauty of doing it within center or in state is that the transport times for the donated organs are very, very short. So, your chances of encountering a problem related to transportation go down or is nonexistent, whereas if you're shipping organs out of the state or across the country the theoretical risk of transportation goes up," Dr. Ellis added.
For donors like Dean, there are risks associated with the surgery, but they are considered fairly minimal. "Based on literature that's available, assuming the donor is healthy and a good donor is, about 3 out of 10,000 people will have some sort of surgical problem. If you put that into a frame of reference, about 6 out of 10,000 people have problems taking an appendix out and about 9 out of 10,000 people have a problem taking a gall bladder out. Those are considered very routine surgeries and this is considered even safer than those," Dr. Ellis said.
Dean was ready for the procedure when he talked with NewsChannel 15 on Sunday night. He said he was ready for recovery and had already thought of all the "what ifs." "What if someone close to you were to need it? What if someone else were to need one? I certainly won't be entering any martial arts competitions anytime soon, but I'm going to put my trust in the good Lord. I don't live in fear, I don't live in doubt, I don't live in worry and I know that when my final day comes, I know where I'm going to be and this is just a step in my life the good Lord wants me to take," Dean said.