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Medicine Science Technology

Doctors Transplant Same Kidney Twice In Two Weeks 130

Posted by samzenpus
from the reduce-reuse-recycle dept.
kkleiner writes "Twenty-seven-year-old Ray Fearing suffered from focal segmental glomerulosclerosis (FSGS), a common type of kidney disease, and needed a new kidney. His 24-year-old sister, Cera Fearing, wanted to give him hers. The transplanted kidney immediately began to grow diseased, so doctors removed it. But then something happened that, according to the doctor who performed the procedure, had never been done before. The unhealthy kidney was removed from Ray, and replanted into another patient, and the kidney became healthy and has remained in this second patient ever since."
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Doctors Transplant Same Kidney Twice In Two Weeks

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  • its Ray "Fearing" Kidney.
  • by Anonymous Coward

    We'll make it fit SOMEPLACE!

    Yeah.. not the attitude i want a surgeon to have... What happens when the person who ended up with it gets a new disease...

    • by wisnoskij (1206448) on Sunday April 29, 2012 @03:52PM (#39839113) Homepage

      You know that there is a always far more demand then availability.
      No matter what happens it probably saved a life.

      • by sco08y (615665) on Sunday April 29, 2012 @04:33PM (#39839287)

        You know that there is a always far more demand then availability.
        No matter what happens it probably saved a life.

        There's an adequate supply, it's just illegal to sell organs.

        • The easy road would be to make being a Organ-Donor opt-out, not opt-in.
    • by Morty (32057) on Sunday April 29, 2012 @04:40PM (#39839329) Journal

      I think the assumption was that the brother's disease, which was genetic, was causing problems with the new kidney. But because $recipient2 did not have that disease, if transplanted to $recipient2's body, the kidney would recover and work correctly. A genetic disease not present in the kidney should not follow the kidney. The actual results would vindicate that theory.

      • by clang_jangle (975789) on Sunday April 29, 2012 @05:03PM (#39839441) Journal
        You are correct -- the value of this is the discovery that when an organ is diseased it may be a symptom of a greater problem. It actually seems pretty obvious when you think about it.
      • by chooks (71012)

        I think the assumption was that the brother's disease, which was genetic, was causing problems with the new kidney.

        Not quite: FTFA:

        Researchers have theorized that it may be caused by a factor circulating in the bloodstream.

        From something a little less...mainstream:

        Idiopathic or primary FSGS is postulated to result from a plasma factor that increases glomerular permeability. This hypothesis is supported by the observation that FSGS may recur in a renal allograft. However, the presence of such a permeability factor has not been confirmed although some of its characteristics have been described. Another possibility to explain the pathogenesis of FSGS is lack of an inhibitor to the permeability factor. Hence, what causes FSGS and why it may recur in a transplanted kidney is yet unknown.

        (Szczepiorkowski ZM, Winters JL, Bandarenko N, et al. Guidelines on the use of therapeutic apheresis in clinical practice--evidence-based approach from the Apheresis Applications Committee of the American Society for Apheresis. Journal of clinical apheresis. 2010;25(3):83-177.)

        Usually FSGS is thought to be acquired (e.g. HIV or heroin use) rather than genetic. Of course, underlying genetics or haplotypes may play a role, but I too lazy to look that up :).

  • Doctor: We don't have any kidney's available but we have this diseased and rejected kidney in the fridge. Intrested? Patient: Umm... F*** it. Dieing anyway right? Throw it in!
    • Re:uHHH.. (Score:5, Funny)

      by Black Parrot (19622) on Sunday April 29, 2012 @03:51PM (#39839107)

      Doctor: We don't have any kidney's available but we have this diseased and rejected kidney in the fridge. Intrested?

      If you're going to receive a transplant, it's best to get an organ with broad experience.

    • by Anonymous Coward

      Actually, when you're on the kidney transplant list (at least in the USA) you have the choice between optimal and suboptimal kidneys. In other words, if you're really hating dialysis, you can get whatever the first kidney is that comes along that will match your blood group, even though it might be from someone old and with a potential disease. If you want to hold out for a good one, you can.

  • The article doesn't give much detail.
    I assume this is part of a clinical trial being done. Otherwise it would seem odd logically or ethically to do this.
    You can live without a kidney(ies) but a transplant is a major surgery with real risks. Judging by the talk about the theory of the blood born cause it must have been a clinical trial.

    If someone here is a surgeon maybe they could explain the ethics involved when approving this type of novel operation?

    • by Anonymous Coward

      Actually the first linked TFA gives just the right amount of detail:

      "To me giving it to someone else seemed like the right thing to do," said Ray Fearing, who undergoes dialysis several times a week and is not currently a candidate for another kidney. "This was a gift to me, and I wanted to pass along the gift. I didn't realize what a big thing it was at the time."

    • by cpu6502 (1960974)

      >>>clinical trial

      Or Dr. House breaking the rules again! (Damn him... if we wasn't so good, we'd prosecute him in court.) ;-)

      I'm surprised the kidney got better. I guess the disease is located in the man's body, not in the kidney (which recovered once given a healthy environment). I feel sorry for the guy as he'll probably die soon, before he even made 30.

    • by u38cg (607297)
      Actually, you've got it exactly backwards. Doctors are entirely free to do things in everyday practice using their own judgement that, were they involved in a trial, they would not be permitted to do.
  • by bitt3n (941736) on Sunday April 29, 2012 @03:56PM (#39839135)
    get one patient to reject the kidney, and then, while the it's still depressed, another patient gets the kidney on the rebound.
  • Most Importantly (Score:5, Informative)

    by Thinine (869482) on Sunday April 29, 2012 @04:02PM (#39839155)
    His sister is hot.
  • I had some Ram that did that once. Placed it in one PC and I had an unstable system constantly crashing.

    take it out and put it in another box. Both machines running perfectly.

    • by EnsilZah (575600)

      Well, sheesh, I thought it was commons knowledge that putting farm animals in your computer case would cause some instability, especially ones with horns.

  • The Meaning of Life Part V: Live Organ Donor Transpants

  • by Anonymous Coward

    The girl that donated the kidney is SMOKING hot.

  • It's obvious that Ray is cursed.

  • by cvtan (752695) on Sunday April 29, 2012 @04:45PM (#39839353)
    Kidney once, shame on you. Kidney twice, shame on me.
  • by Anonymous Coward

    I still don't understand why not everybody is considered as donor.

    In Luxembourg, Austria, Poland, Portugal, Slovakia, Slovenia, Spain, Czechoslovakia and Hungary (Wikipedia page only lists European countries) you have to actively exclude yourself.

    • Do they force all healthy 21+ to "donate" a kidney? Obama, you may take our freedom by the TSA, but you won't take our Kidneys!!!
      • No, they don't force healthy people to give their kidneys.
        They take your organs when you die. (When you die in specific circumstances. They don't want damaged organs, of course.)

  • Ports (Score:4, Insightful)

    by lannocc (568669) <shawn@lannocc.com> on Sunday April 29, 2012 @05:26PM (#39839603) Homepage
    Just goes to show that human-parts package management should be treated like a BSD Ports or Gentoo Portage installation; you need to take the entire system into consideration when looking at changes.
  • You no like the kidney??
    No kidney for you!

  • by countach (534280) on Sunday April 29, 2012 @05:51PM (#39839749)

    Why didn't the girl get the kidney back? I can understand her willing to give it up for her brother, but not for some random person.

    • by mpoulton (689851)

      Why didn't the girl get the kidney back? I can understand her willing to give it up for her brother, but not for some random person.

      Because she's fine with only one kidney, and the risks of reinstalling the other one are very substantial for almost no benefit.

      • by EdwinFreed (1084059) on Monday April 30, 2012 @01:07AM (#39842143)
        Substantial risk understates the situation if anything. The fact is removing a kidney is a pretty big deal whereas putting one into someone is a lot simpler. This is because they put transplanted kidneys into the lower abdomen inside the muscle layer but outside the peritoneal wall. (The old failed or failing kidneys are only removed if absolutely necessary.) Removing a kidney, OTOH, means going through the abdomen to the other side. Even though it's done laparoscopically, it's still fairly traumatic, to the point where altruistic donors (that's what they are called) have a significantly worse time of it than the recipient in the first couple of weeks post-transplant. Because of this, there is no way in hell any remotely competent surgeon would agree to put back a kidney they are sure she doesn't need so soon after the original procedure. (Donors undergo extensive testing before such procedures. And it's actually surgeons plural, since reattaching blood vessels and hooking up ureters are actually different specialties.)

        For that matter, they would not have removed the transplanted kidney from the original recipient were it not for the small matter that according to the article, it was killing him. (When a transplanted kidney fails and another transplant is done they don't remove it unless absolutely necessary, with the result that someone can end up with four or more kidneys.) So they were going to end up with a kidney and no place to put it. Rather than toss it in the garbage, my guess is they started calling people at the top of the list who were type compatible until they found one willing to give it a go.

        I'll also point out that one of the side benefits of being a donor is that in the unlikely event that your remaining kidney fails, you automatically go to the top of the transplant list. And in most cases 100% of the donor's costs are paid for.
    • by GreatBunzinni (642500) on Sunday April 29, 2012 @06:44PM (#39839989)

      They removed the kidney from her brother because they believed it was already broken. So, they instead transplanted it to the desperate 67 year old guy who prefered getting a diseased kidney, hoping it could extend his life for a little bit, instead of passing it to a perfecly healthy person, which might put her life in jeopardy.

      Or so I believe.

    • Fortunately for humanity, lots of people are willing to donate a kidney to save a stranger's life.

      http://www.nytimes.com/2012/02/19/health/lives-forever-linked-through-kidney-transplant-chain-124.html?_r=2&pagewanted=1 [nytimes.com]

  • His 24-year-old sister, Cera Fearing, wanted to give him hers.

    - she wanted to give him hers, well, if they could transplant it into another patient, then she should be suing the shit out of them for not transplanting it BACK INTO HER.

    • by u38cg (607297)
      Alternatively, perhaps she bothered to learn a tiny little bit about the implications of kidney transplantation beforehand and happens to know why that doesn't make sense.
      • by roman_mir (125474)

        Bull, she just wasn't told what was going to happen to her kidney and that it could be implanted back into her. She should sue, in fact I am going to email her the suggestion.

  • Did the 2nd recipient get it at a discount?

    • by erice (13380)

      Did the 2nd recipient get it at a discount?

      In a sense, yes. Organs are always in short supply and priority is given to the young and healthy (aside from needing an organ, that is). The second recipient was a 67 year old diabetic. Through normal channels, he probably could not get a kidney at any price.

      • That may be true for other organs, but not kidneys. And this is for good reason: With, say, a heart or lung or liver, you either get one or you die in fairly short order. But we have an acceptable substitute for a kidney: Dialysis. So, issues of compatibility and availability aside, kidneys are allocated on a first-come-first-served basis,

        What this translates to in practice is that if you're blood type O, expect a *long* wait. This is mostly because type Os can only get a type O kidney, meaning about 60%
    • by VickiM (920888)
      A 67 year old man would probably be on Medicare. So it was more likely double-billed than discounted.
      • Medicare. Double-billed at 1/5 of the cost to do the work still has the Doctors losing money. .... And people ask me why Hospitals near large elderly housing are closing down.
      • Actually, end stage renal disease (ESRD) including both dialysis and transplants, is covered by Medicare regardless of age. The only other condition that enjoys this status is amyotrophic lateral schlerosis (ALS). I have no idea why ALS is handled this way, especially since there are several similar motor neurone diseases that aren't covered, but in the case of ESRD, it's because when dialysis was first developed it was extremely expensive and insurance refused to cover it. The result was few dialysis machi
  • If I was going to get a kidney, it'd better be from myself [wikipedia.org].

  • 4 day old receives transplant and new life on Slashdot.

    -AI

  • by X10 (186866)

    sounds like Dr House was there.

  • Thought they returned it to the sister.
  • Wow, considering this was the "first time" for this to happen, the patient must have been very desperate.

    "We have a kidney available, however it is 3rd hand, and currently diseased, and no one has ever transplanted a diseased kidney and have it get better on its own. Still want it? Yes? Really?"

Wernher von Braun settled for a V-2 when he coulda had a V-8.

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