Since Loyola University Medical Center launched its Pay-it-Forward Kidney Donation Program, 21 more good Samaritan donors have stepped forward, potentially leading to 126 or more people receiving transplants around the nation.

"We've had 50 phone calls from people of all ages and backgrounds who heard about the program and who expressed desires to donate kidneys," said Loyola kidney transplant surgeon Dr. John Milner, who helped spearhead Loyola's Pay-it-Forward initiative. "Those donors should be commended for helping us to unlock the potential of chains to get more people transplanted who might otherwise never have a chance for a new life."

A Pay-it-Forward kidney transplant begins when an altruistic donor steps forward to donate a kidney to a stranger, beginning a chain. The donor's kidney is then given to a compatible transplant candidate who has an incompatible donor who then agrees to give a kidney to a third person with an incompatible donor, and so on. Potentially, a chain can go on forever.

Loyola's Pay-it-Forward Kidney Transplant Program began with four people who offered to donate kidneys to four complete strangers with no strings attached. The program is the first of its kind in the Midwest and boasts the largest number of altruistic donors to ever launch such an initiative in the United States, according to Garet Hill, founder of the National Kidney Registry, the nonprofit organization that coordinates the donations.

The donors were Christina Lamb, 45, of Melrose Park, Ill.; Cynthia Ruiz, 22, of La Grange, Ill.; Jodi Tamen, 45, of West Frankfort, Ill., and Tim Joos, 53, of St. Charles, Ill.

Since Loyola's Pay-it-Forward program began in March, Lamb has donated a kidney to Robert Rylko of Rockford. Also, Tamen's kidney was removed at Loyola and flown to a patient at the UCLA Medical Center in Los Angeles and Joos' kidney was removed at Loyola and flown to a patient at the Pinnacle Health System in Harrisburg, Pa.

Tamen and Joos, who have both recovered and returned to normal activities, have never met their recipients.

"That's one of the advantages of the Pay-it-Forward concept. You can ship a kidney and not a donor. That's the first time that has ever happened in the Midwest," Milner said. "Donors have the luxury of being in familiar surroundings with their friends and family while they recover. There are already so many disincentives to donation, why add another by making the donor, as well as family members, travel?"

Another early beneficiary of the Pay-it-Forward Program is 19-year-old Melissa Clynes of Florrisant, Mo., whose kidneys were destroyed by medication she has taken since infancy when she had a heart transplant. On March 29, Melissa received a kidney from Ruiz at Loyola.

"Melissa is feeling fantastic," said Mary Clynes, who for years searched desperately for a donor who matched her daughter. "To see her feel so good and be able to live and enjoy life again gives me so much joy. No longer are my days filled with anxiety and depression. None of that would have been remotely possible without the help and expertise of the Pay-it-Forward Program at Loyola."

A Pay-it-Forward kidney transplant can easily be confused with a paired donation, in which a transplant candidate has a willing donor who is incompatible. In this instance, the pair is matched with a compatible pair in the same situation and they go on to swap kidneys. Since paired donations are typical arranged within the walls of a single medical center, it can take more time to locate compatible matches. Though paired donations can occur outside of a single institution, there are additional problems that affect the quality of the match.

"Paired donations are severely limited because of the need for a reciprocal match, unlike in chains. We got about 20 calls from patients around the country who had willing donors but couldn't find compatible donors to initiate paired donations," Milner said. "We referred those people to the National Kidney Registry. I'm confident they will more quickly find matches like our patients did."

Paired donations, however, have other limitations. In most instances, a donor has to deal with the hassle and expense of traveling to a recipient's location. Also, surgeries have to be performed simultaneously in the same hospital since a donor could decline to donate after their partner receives a kidney from the other pair. Under the Pay-it-Forward concept, if a donor drops out, another chain is started.

"Although it may not be as dramatic, one of the main advantages of a Pay-it-Forward transplant is that the surgeries don't have to take place simultaneously, in the same hospital or even in the same city," said Loyola transplant surgeon Dr. David Holt who also helped spearhead the Pay-it-Forward concept at Loyola. "What is dramatic is that the Pay-it-Forward Program will get more people transplanted with better matched kidney."

Loyola University Health System

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