EP26: Transplants

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Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, my name is Dr. Warrick Bishop and I'd like to welcome you to my consulting room. Today I'd like to share with you a story - a bit of information that I got from a meeting I went to recently. And to be honest it was one of the most impressive "wow" moments I've had in medicine for a long time. I went to a meeting which was centered mainly on cardiology but we had the opportunity to sit in on a session given by a specialist in transplant medicine, and to be honest that's not my area at all so most of it was all pretty new to me. All sorts of things get transplanted as you're aware. Corneas, hearts, lungs, livers, kidneys etc.. It is an opportunity for a sad occurrence which can be the injury or death of someone to give rise to something really special and help another individual. Anyway, what I would like to tell you about is renal transplants from living donors.

So, it's a pretty simple concept. Imagine a couple, Bob and Mary. Let's say for argument's sake, Bob has renal failure and therefore bad kidneys and he's on dialysis. Let's say Mary loves him very much and would like to donate a kidney to her husband to help him out. Well it's all that simple. The tissue markers all have to match up so it's quite possible that even though Mary wants to help her husband Bob she is unable to do that because her kidney would just be rejected by his body. Well, Bob and Mary can now go on something that they call a "kidney donor registry" and on that kidney donor registry, the tissue types for Bob and Mary are listed, and of course they're recognized as Bob needing a kidney and Mary able to donate one. Let's imagine on that registry if there's another couple; say John and Elizabeth.

In John and Elizabeth's case, let's say Elizabeth needs a kidney. Her husband John wants to give her a kidney but their tissue types don't match. However, if they're both on the register and someone looks at the registry and sees that Mary's kidney might suit Elizabeth, and John's kidney might suit Bob, then there is an opportunity for, if you like a domino swap over, where one family are literally giving a kidney to another family in an exchange. Of course, you'd be pretty lucky to only have two people or two couples on a list for that to be able to happen. So you actually need a few lined up. It turns out that this is exactly what happens, and in Australia, the record for the most number of people undergoing renal transplant in one session in one setting based on a registry donor register; on a registry of donors and recipients, the maximum number in Australia was seven operations all in a domino effect to result in everyone donating and receiving kidneys as appropriate. And that's just fantastic. You can imagine the kidney going to here and there, one being received here and there, just crossing over.

I actually sat back and thought that was fantastic until during this presentation they said that the record in America for this occurring was 50 kidneys being transplanted in one go. Now I just sat back in my chair and went wow. That is just the most amazing medicine. It's just incomprehensible. It is fantastic to think that people can share with other people for everyone's good. I have to say it was completely new to me. It left me with a very warm smile. I was genuinely moved by thinking about that. So I thought I'd share that with you because is a remarkable bit of modern medicine and it's just so positive. I will say, and I'll put a plug in here for the transplant doctors, that not enough people have the conversation about transplant and not enough families are prepared about that conversation.

So if I can leave you with a thought, can I please ask you to think about transplantation if anything were ever to happen to you or your loved ones. Please have that conversation. It may not be something that you talk about over dinner but it might be something you talk about quietly within the family from time to time because that gift of giving an organ to someone else; of helping someone else's life move on, is just a remarkable opportunity. One of the reasons that there's a lack of transplantation tissue available is through lack of education and a lack of awareness, where families just haven't had the chance to think about it. So, I hope you like the domino kidney transplant story but I really would like to think about whether you would transplant or whether your loved ones would transplant if that situation ever arose. I strongly encourage you to have that conversation and I really encourage you to think about it.

As always, thank you for joining me. I wish you the very best in health and bye for now.

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