Domino transplants around the world

The kidney transplant swap between four patients in different areas of Canada on Thursday was the first national “domino” transplant procedure. But these types of transplants have taken place in many other countries. Global News takes a look at domino transplants worldwide.

One of the most complex domino transplants ever was a double-six kidney domino performed at Johns Hopkins Hospital in Baltimore, Maryland. Six patients received kidneys from six unrelated living donors on April 5, 2008.

The entire procedure started with the emergence of an altruistic donor who matched one of the patients in need of a transplant.

The five other patients involved had a friend or relative willing to donate their kidney that did not match but was compatible with another patient in the group of six.

The 13-hour procedure required nine surgical teams, made up of about 100 medical personnel.

The double-six domino operation followed a four-way kidney transplant at Chicago’s Northwestern Memorial Hospital on April 3. This procedure also involved an outside donor, Northwestern Memorial transplant nurse Doug Penrod.

Penrod’s plans to donate to a friend fell through, so he decided to become a “blind donor,” donating to someone he had never met. The altruistic move got the process started.

Johns Hopkins Hospital also pulled off the first quintuple kidney transplant on November 14, 2006. Simultaneous operations took place at the hospital on the five patients in need of transplants, in a procedure again made possible by an altruistic donor.

The first domino liver transplant in the U.S. was performed in 1996. For ten years, 17-year-old Rondie Ann Harris had suffered from pseudo obstruction, a condition of the intestines where they cannot digest food.

She was fed through a feeding tube for more than four years before the operation at Jackson Memorial Hospital in Miami. The girl received a liver and a large and small intestine from one donor and then gave her own healthy liver to a third patient at the hospital.

Harris’ body rejected the donor organs she received and she died the next month.

The world’s first four-way domino liver transplant took place in Japan in 1999. It was also Japan’s first domino procedure.

At Kyoto University Hospital, the initial donor gave a part of his liver to his brother, while his brother’s liver was split and given to two other women.

In 2003, Israel performed its first ever domino transplant when the family of a young Palestinian boy who was killed in an accident donated his organs to save the lives of four Israeli children.

Eleven-year-old Qaher Aoude died when he hell off the roof of his family’s home near Nablus in the West Bank. After 34 weeks of armed conflict between Palestinians and Israelis, his family authorized the donation of his organs to other children, regardless of whether they were Palestinian.

His heart and lungs were donated to 13-year-old Cutar Zouabi, a patient suffering from cystic fibrosis. Zouabi’s healthy heart was donated to 11-year-old Rim Jabrin.

Aoude’s liver and kidneys were given to two other children.

One of the major roadblocks involved with domino procedures is not physical, but ethical. First, there is a danger that when a patient receives the donated organ, their loved one will change their mind about donation.

In order to prevent this, operations are usually scheduled to occur simultaneously.

Another issue is the example of a hospital that receives an emergency liver failure case as they are about to perform an elective domino liver operation. They face an ethical dilemma of who should receive the liver.