Kidney Transplant

In the real world, organ transplant physicians use sophisticated computer programs to find scarce donors of medically compatible kidneys for their most desperately ill patients. It's math saving lives. But in Hollywood, writers for the hit CBS crime drama Numb3rs wondered whether the FBI could use the same organ-matching mathematics in reverse - to track down the most likely recipient of a black-market kidney, so they can nab the criminals behind the scheme. That's math catching crooks, and it's the premise of tonight's episode of Numb3rs, with a script inspired by organ-pairing mathematics done at the Johns Hopkins University School of Medicine.

To take over for her failing kidneys, Madeleine Therrien, 63, of Merrimack, N.H., tried a home dialysis system that flushed her abdomen with fluids several times a day. But, as often happens with this kind of treatment, known as peritoneal dialysis, she wound up in the hospital with a painful abdominal infection. So she switched to hemodialysis three times a week at a clinic, which was effective but meant sitting for four hours each time, hooked up to a machine that cleansed her blood.

A larger, more efficient system for matching kidney donors with recipients would save hundreds of lives and hundreds of millions of dollars every year, according to a new study by researchers at the Johns Hopkins Hospital and the Massachusetts Institute of Technology. Their paper, published this week in the Journal of the American Medical Association, looked at paired donation, a relatively new transplant method that has grown more popular in recent years. Here's how it works: For a kidney transplant to be successful, the donor and recipient must be medically compatible.

Last May, when Elizabeth-Ann Mohammed learned that her kidneys were failing, she was given two choices by her doctor: endure years of dialysis or find someone to donate a kidney. But because she is black, finding a kidney wouldn't be easy. On average, black patients wait nearly five years for a kidney transplant - about 18 months longer than their white counterparts. The reasons for this disparity, experts say, involve genetics, economics and donor rates. Regardless, the numbers reveal a harsh reality.

DETROIT - Americans who get a second chance at life with an organ transplant often go on to develop kidney failure and sometimes die of it, according to the largest study on the issue. The study, published in today's New England Journal of Medicine, has important implications for the 82,581 Americans waiting for transplants. "The message is there's an increased risk of kidney failure, that people should know about it, and they should be prepared to go through another transplant," said Dr. Akinlolu Ojo, a University of Michigan transplant specialist and senior author of the study.

It sounds like one of those logical brainteasers that almost no one can solve: You have three pairs whose partners don't match each other but might match members of other pairs. By shuffling, can you come up with three perfect matches? The answer was a happy "yes" at Johns Hopkins Hospital, where 15 doctors operated on six patients over 11 hours Monday to transplant three healthy kidneys into three desperate recipients. The "triple switch" was almost certainly the first such maneuver in history, Johns Hopkins officials said.

Maryland Health Secretary Nelson J. Sabatini said yesterday that his department will resume paying for a new immunosuppressant drug used by kidney transplant patients in a state-funded program. But Sabatini said restoration of coverage for the drug known as Rapamune will not affect a decision to halt reimbursement for about 80 other pharmaceuticals that were dropped from the Maryland Kidney Disease Program in mid-April. His action on Rapamune followed a barrage of protests by patients, advocates and kidney specialists who said the ban on the drug was putting patients at risk because there is no known substitute.

Saying they have no choice under state law, Maryland health officials have cut access to 80 drugs for about 2,350 kidney transplant patients because the pharmaceutical manufacturers refused to participate in a mandatory rebate program. The action triggered protests and warnings of dire physical consequences to patients in the $10 million-a-year Maryland Kidney Disease Program, which covers transplant and drug costs for those who aren't covered by federal Medicare benefits or private insurance.

John Dellenback, 84, a former Oregon congressman, died of viral pneumonia Saturday in Medford. The southern Oregon Republican wrote legislation establishing the vast Oregon Dunes National Recreation Area. He also wrote amendments to a bill allowing the construction of the Alaska oil pipeline, holding pipeline permit-holders and shippers liable for oil spills. Mr. Dellenback was elected to Congress in 1966. He held leadership posts in education and natural resources, but lost his re-election bid in 1974 after four terms.

A $1 million gift from Drew Bauer, part-owner of the St. Louis Cardinals, will be used to establish a professorship in transplant surgery at the University of Maryland School of Medicine. Bauer, who received a kidney transplant at the medical center three years ago, said at a gift-giving ceremony yesterday that he wanted the professorship to advance research and encourage organ donations. The teaching position is being named for his sister, Barbara Bauer Dunlop, who donated a kidney to him. "I can't think of a better way to honor my sister, who saved my life through her brave and unselfish act," said Bauer, whose transplant was performed by a team led by Dr. Stephen T. Bartlett.