Science, Individualized Medicine, and Passion Drive Chains of Kidney Transplant Pairings – A
The front page of the NYT this morning is dominated by a mosaic picture of 60 people who form a chain of 60 lives and 30 kidney transplants driven by domino chains of linked donations. The story by Kevin Sack is a remarkable tale and vividly illustrates the goodness of many people. The story focuses on a donation chain set in motion by the National Kidney Registry, a non-profit driven by a couple with a daughter who at one time needed a kidney transplant.
The heart-warming and remarkable story deserves a leisurely Sunday morning read to nurture faith in mankind. And, after the feel good part, consider the story’s subtle but clear lessons on the human and financial gains resulting from investing money and time in collaborative, creative and passion-driven teams bringing to fruition the power of science in this new age of individualized medicine. Specifically, the chain of paired donations – and thus cures – was driven by:
scientific tests able to distinguish among people at incredible levels of detail in order to vastly reduce the rate of transplant rejection, and thus make the best use the limited resource of donated kidneys,
a father with passion, money and skills in differential equations and computers – with help from others, he built programs able to quickly find and identify potential matches based on the scientific testing tied to the individualized blood types and antibodies of both donors and patients in need, and
a physician creative enough to see the possibility of donation chains that would cross over the usual boundaries of families and friends to become an essentially unbounded chain,
The investment outcomes are fabulous. The story focuses on one particular chain of 60 people and 30 kidneys, but there are many more successful chains. The results are online at the web site. Read the full story and imagine the suffering avoided and the lives restored.
And, the investment also produces a fabulous financial return. So, the next time someone suggests cutting science budgets, follow Nancy Reagan’s advice to "just say no" and then point the speaker to the following numbers quoted from Mr. Sack’s article:
"Domino chains, which were first attempted in 2005 at Johns Hopkins, seek to increase the number of people who can be helped by living donors. In 2010, chains and other forms of paired exchanges resulted in 429 transplants. Computer models suggest that an additional 2,000 to 4,000 transplants could be achieved each year if Americans knew more about such programs and if there were a nationwide pool of all eligible donors and recipients.
Such transplants ultimately save money as well as lives. The federal Medicare program, which pays most treatment costs for chronic kidney disease, saves an estimated $500,000 to $1 million each time a patient is removed from dialysis through a live donor transplant (the operations typically cost $100,000 to $200,000). Coverage for kidney disease costs the government more than $30 billion a year, about 6 percent of the Medicare budget."