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  News - Addenbrookes Hospital, Cambridge Cambridgeshire UK
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New era in kidney transplantation begins at addenbrooke's
Date : - 04/12/2007
Roma Horrell, 57, needed a transplant after her kidneys failed. Her husband Peter, 55, wanted to donate – but couldn’t, because their blood groups are incompatible. So they registered with a new scheme designed to help people in their situation – and ended up as part of a two-way kidney swap with a couple from Scotland.

"I still can't quite believe the pairing scheme means I've got a new kidney,” says Roma. “I was deteriorating so quickly before the transplant: sleeping 18 hours a day, finding it difficult even to walk. Sometimes I'd wake up after nine hours’ sleep, have breakfast, then go back to sleep. After lunch, I’d sleep again. Whatever I was doing, I had to keep stopping to rest. Even simple household tasks were too much."

“We already know that living kidney donation works well and saves lives,” says Professor Andrew Bradley, Director of Transplant Surgery at Adddenbrooke's. “But when someone like Peter comes forward and wants to donate a kidney to his wife, we've got to establish that the transplant will work. The donor and recipient need to have compatible blood groups, and the recipient mustn't have antibodies that will make them reject the new organ. About a third of our potential living donors – including Peter – turn out not to be compatible with the recipient. They want to donate, but they can't. That's where this new pooling scheme comes in.”

The pool, which is designed for situations like this where one partner cannot donate directly to the other, was set up after the Human Tissue Act came into force earlier this year. The change in the law meant that this kind of transplantation was allowed for the first time. Essentially, if Mr A wants to donate to Mrs A, but can’t, and Mr and Mrs B are in the same situation, a computer will look at their cases to see if Mr A can donate to Mrs B, and Mr B can donate to Mrs A. The reality is somewhat more complicated than that, but the end result is that a transplant involving two donors and two recipients becomes possible – and when the UK Transplant computer looked at potential pairs in April this year, it identified the Scottish couple as a possible match for Peter and Roma.

“Peter and I completed all the tests and then we forgot about the pool,” says Roma. “When we heard in May that a match had been found I could hardly believe my luck. I never expected to receive a 'live' kidney.”

The four operations went ahead on 4 July. Surgeons at Addenbrooke's removed a healthy kidney from Peter at the same time as their colleagues in Edinburgh operated on the female donor. Her kidney was rushed to Marshall's Airport in Cambridge by plane, then the plane returned to Edinburgh with Peter's kidney on board. The donated organs were then simultaneously transplanted into both recipients. Roma and Peter were discharged from Addenbrooke's in less than a week.

For Peter, there was never any question that donation was the right thing to do: “If you'd seen your wife deteriorate as rapidly as I did, you wouldn't have had a problem with donating your kidney. I've helped her get better, even if my kidney has gone to someone else. I still feel as though I donated to Roma even though I couldn't do it directly – and it would never have been possible without the pool.”

The surgeons involved believe the new law will mean new hope for at least some of the 6,500 patients in the UK who are currently waiting for a kidney transplant. For these two couples, it could mean long-term freedom from dialysis and a new chance at life.

“We are more than grateful for the pool,” says Roma. “It has saved my life. Everything has improved enormously: I can eat what I want, I can enjoy cooking, we can go on holiday. Life is normal again. I feel as though I've got hope for the future.”

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