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On Valentine's Day, one of the nation's first three-way living-donor kidney transplant chains was initiated by NewYork-Presbyterian Hospital/Weill Cornell Medical Center and its medical partner The Rogosin Institute. The innovative approach — a NEAD (never-ending altruistic donor) chain — may dramatically improve the opportunity for patients in need of kidney transplants to find a compatible donor and potentially revolutionize the organ transplant process in the United States.

This life-saving chain began with the generosity of a California woman who donated her kidney to a stranger in New York City, resulting in life-saving kidney transplantations for three patients — and, going forward, potentially benefiting hundreds of the 74,000 kidney patients on the national transplantation waiting list.

In this remarkable arrangement, a family member of each recipient volunteered to donate his or her kidney to another patient in need. The first three successful transplants took place Thursday, Feb. 14, with future surgeries to follow.

All three kidney recipients met their previously anonymous donors for the first time today at a press conference held at NewYork-Presbyterian/Weill Cornell.

"This approach could revolutionize the way we do living-donor transplants in this country, greatly reducing, even eliminating the organ shortage in this country and ultimately saving the lives of those in desperate need of a kidney," says Dr. Sandip Kapur, who led the transplantation surgeries. Dr. Kapur serves as chief of transplant surgery, director of kidney and pancreas transplant programs and associate attending surgeon at NewYork-Presbyterian/Weill Cornell, and associate professor of surgery at Weill Cornell Medical College.

The recent surgeries involved six surgical transplant teams, including 40 clinicians, working simultaneously in six operating rooms. Along with Dr. Kapur, NewYork-Presbyterian/Weill Cornell physicians and surgeons participating in the kidney swap procedures included Drs. Joseph Del Pizzo (director of laparoscopic and robotic surgery for the Division of Urological Surgery and assistant professor of urology), Alfons Pomp (chief of the section of laparoscopy and bariatric surgery and the Leon C. Hirsch Professor of Surgery), Eduardo Perelstein (pediatric nephrologist and associate professor of clinical pediatrics), David Leeser (assistant attending surgeon and assistant professor of surgery) and David Serur (medical director of The Rogosin Institute Transplant Center at NewYork-Presbyterian/Weill Cornell and associate professor of clinical medicine and medicine in clinical surgery).

Three Recipients, Three Donors — All Links in the Chain

The multiple transplantations were made possible by a 51-year-old accountant from California who was inspired to donate after her husband donated a kidney to his brother 12 years ago.

The initial donation was made to a 58-year-old Hollis, Queens, woman who moved to the U.S. from Bolivia 25 years ago and suffers from diabetes, lupus and high blood pressure. She has been on dialysis for the past three years. Her husband, a 60-year-old cabinet-maker, then donated his kidney to a 32-year-old Long Island City, Queens, woman, who moved here from Bangladesh in 1993 and has spent 18 months on dialysis. Her husband, a 42-year-old street vendor, then donated his kidney to a 5-year-old Manhattan boy who has nephrotic syndrome and has spent almost half his life on dialysis.

That boy's father, a 46-year-old data clerk who has worked at NewYork-Presbyterian/Weill Cornell for 15 years, will act as a bridge donor to the next cluster of transplants, which have already been identified by the National Kidney Registry. Founded by business executive Garet Hil after overcoming a difficult search for a living donor for his daughter, the National Kidney Registry aims to register all incompatible and poorly-matched donor-recipient pairs in the U.S. to better facilitate living donor transplants.

Each cluster of the chain consists of an equal number of donors and recipients. After the first round of transplants, a family member or friend of one recipient acts as the bridge donor that initiates the next cluster.

Dr. Kapur says that as more transplant centers enter their incompatible pairs with the registry, the probability of finding suitable matches and performing successful transplants will improve geometrically.

"If we evolve to the point where everyone brings a prospective donor and enters them into this pool, we can provide quicker transplants for a greater number of people," Dr. Kapur says.

As opposed to traditional paired exchanges, donor chains further extend the opportunity of receiving life-saving organs to a countless number of patients.

"Most paired exchanges are double or sometimes triple swaps, but then it ends," says Dr. Serur. "One important advantage of a donor chain is that, with an extra donor in the beginning, you can initiate a self-propagating cascade."

Organ Transplantation at NewYork-Presbyterian Hospital

The organ transplantation program at NewYork-Presbyterian Hospital — which includes NewYork-Presbyterian Hospital/Weill Cornell and NewYork-Presbyterian Hospital/Columbia and The Rogosin Institute — the most active program of its kind in the nation, offers comprehensive and personalized care for the heart, liver, pancreas, kidney and lung. With outcomes ranked among the nation's best, the Hospital is dedicated to improving quality of life for its patients. NewYork-Presbyterian's dedicated teams of surgeons and physicians are responsible for many significant advances made over the past several decades in transplant surgery and the maintenance of healthy organs. The Hospital has been on the forefront of developing and improving anti-rejection medications (immunosuppressants), minimally invasive surgery for living donors, genetic methods to detect transplant rejection, strategies to increase opportunities for donor matching, islet cell transplantation and the FDA-approved Left Ventricle Assist Device (LVAD) that functions as a bridge to transplantation for those waiting for a new heart.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson's disease, the first indication of bone marrow's critical role in tumor growth, and, most recently, the world's first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree oversees and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit www.nyp.org and www.med.cornell.edu.

The Rogosin Institute

The Rogosin Institute is a not-for-profit institution for medical research and treatment in kidney disease, including dialysis and transplantation, and cardiovascular disease related to cholesterol and other lipid abnormalities. The Rogosin Institute also has extensive research programs in diabetes, cancer and endotoxemia. For more information, visit www.rogosin.org.