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National program to swap organs urged

CHICAGO -- Specialists in kidney transplants pushed yesterday for a national program to swap organs that they say could be lifesaving for thousands of ailing patients on transplant waiting lists.

Such swaps, done at about 30 US hospitals now, including New England Medical Center, would involve patients who need transplants and have relatives or friends willing to donate but whose kidneys do not match. Each patient-donor pair would be matched with another pair to allow reciprocal transplants.

More than 60,000 US patients await kidney transplants; last year 3,718 on the waiting list died, because suitable organs could not be found in time, according to the National Kidney Foundation.

''It's quite a gift," said Ron Lazar, of North Canton, Ohio, who received a kidney transplant at the Cleveland Clinic in November after his doctors found an Ohio couple in the same predicament.

Lazar's wife, Kathy, had the wrong blood type, but her kidney was a match for Debbie Pratt, who like Lazar, had life-threatening kidney disease. Pratt's husband, Gary, turned out to be a match for Ron Lazar.

Creating a national paired-kidney exchange would allow transplants for about half the 6,000 US patients yearly who have willing donors with incompatible kidneys because of different blood types or other reasons, said Dr. Robert A. Montgomery, director of Johns Hopkins University's Comprehensive Transplant Center.

''The payoff is huge," said Montgomery, who organized a conference in Chicago, where dozens of specialists gathered to develop a national program in paired-organ exchange.

The average wait is three to four years, and while there are more living than deceased kidney donors, most transplants involve deceased donor organs because two kidneys can be taken from each cadaver. Paired-organ exchanges shorten waiting times and provide kidneys from live donors, which are preferred, because they improve patients' chances of survival, Montgomery said.

About 50 patients have received kidneys through US programs to exchange paired organs. Such programs exist in the Netherlands, Israel, and South Korea.

About 22 patients have received kidneys through the program in paired exchange at Johns Hopkins, one of the nation's first, which began in 2001. Conference participants included specialists from the United Network for Organ Sharing, the national group coordinating transplants.

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