9-way kidney swap involving 18 surgeries at 2 S.F. hospitals

Dr. Andrew Posselt (l to r) and Shyam Raghavan, third year resident, perform surgery to remove the kidney of altruistic donor Reid Moran-Haywood at UCSF Medical Center at Parnassus on Thursday, June 4, 2015 in San Francisco, Calif. less Dr. Andrew Posselt (l to r) and Shyam Raghavan, third year resident, perform surgery to remove the kidney of altruistic donor Reid Moran-Haywood at UCSF Medical Center at Parnassus on Thursday, June 4, 2015 in ... more Photo: Lea Suzuki, The Chronicle Buy photo Photo: Lea Suzuki, The Chronicle Image 1 of / 17 Caption Close 9-way kidney swap involving 18 surgeries at 2 S.F. hospitals 1 / 17 Back to Gallery

The first of 18 surgeries in a nine-way, 36-hour marathon kidney transplant chain began Thursday at UCSF and California Pacific Medical Center in a highly coordinated event that also involves ferrying kidneys between the two hospitals in specialized transport vans.

The two San Francisco hospitals, both experienced transplant centers that typically compete for prowess in the field, joined forces for the unusual swap, which is considered to be the longest kidney transplant chain performed in one city over such a short period of time.

By Thursday afternoon, UCSF was on track to complete its last of four surgeries, and surgeons at California Pacific Medical Center were finishing the final of six for the day, hospital officials said. Two kidneys were transported between hospitals, while the rest were transplanted at adjacent operating rooms.

“There was nothing unexpected, and everything has gone smoothly,” said Dean Fryer, spokesman for California Pacific.

On Friday, both centers conclude the transplants with four surgeries each, and four kidneys will be transported between the hospitals, he said.

Kidney transplant chains like these are becoming increasingly common in the Bay Area as well as across the country. In March, surgeons at California Pacific Medical Center successfully completed a six-way kidney exchange. The procedure involving 12 surgeries with six donors and six recipients was done over two days. It was an unusually long chain for a single hospital.

34-way kidney swap

The country’s longest kidney transplant chain involved a 34-way swap — a total of 68 surgeries — at 26 hospitals around the nation. The transplants occurred over a three-month period ending with the last surgery March 26 in Wisconsin.

Software matching programs have been driving the trend. The programs use blood type and other patient data from medical tests to connect people who are compatible. It allows people who want to donate a needed kidney to a friend or family member with a match even if they’re not compatible with the person they want to give a kidney to. They do so with the understanding that their loved one will be paired with another donor in the chain.

But these exchanges have to start with what’s known as an altruistic donor: someone who is willing to start the chain by donating a kidney without expecting anything in return.

The donor who stepped up to start the chain at UCSF and California Pacific, Reid Moran-Haywood, 56, said it felt like the right thing to do after his kidney wasn’t the right match for a friend in October.

“I’ve been so healthy in my own life, so the idea somebody else may be able to be more active and enjoy the things I can do ... it’s totally worth it, and makes sense to me,” he said Wednesday.

Moran-Haywood, who lives with his husband in Napa and works as a project manager for Kaiser Permanente, said he’s always had his organ donation noted on his driver’s license but never thought he’d be able to donate one while still living.

“It’s really exciting I can do something like this and help someone out in my own lifetime,” said Moran-Haywood.

More than 101,000 people are waiting for a kidney transplant in the United States. Most people receive organs from people who have died, although transplant surgery using a kidney from a living donor has better outcomes and lasts longer.

2 from out of state

The donors and patients involved in the UCSF-California Pacific swap are mostly from the Bay Area with just two from out of state. They include five husband-and-wife pairs, hospital officials said.

Moran-Haywood’s surgery, which was conducted at UCSF early Thursday, went smoothly, said transplant surgeon Dr. Andrew Posselt, associate professor of surgery at UCSF. He said removing the kidney took about 1½ hours.

The kidney was then transported just over 3 miles to California Pacific Medical Center by an organ procurement service, Donor Network West, which specializes in packaging and transporting organs.

While the process is carefully managed, speed is not as high a priority for organs like kidneys and livers, said Noel Sanchez, spokesman for the Oakland company. Those organs can be out of the body for as long as 24 hours if properly preserved, he said. Heart and lungs, in contrast, must be transplanted within a few hours.

San Francisco is in an unusual position to perform multiple-way transplant surgeries because it has two hospitals experienced in performing transplants.

UCSF, which performs about 350 transplants a year from both living and deceased donors, has completed the highest number of paired exchanges nationally in the past year: 28 since June 2014, according to UCSF officials. California Pacific surgeons perform more than 200 kidney transplants a year.

The combined number of patients waiting for a kidney at UCSF and California Pacific is 7,183, which accounts for 7 percent of the entire waiting list for the U.S. and 38 percent of California’s list.

MatchGrid software

To match prospective donors and recipients, both hospitals use BiologicTx Paired Donation kidney matching software called MatchGrid. The program was developed by San Francisco software expert David Jacobs, who came up with the idea after he underwent a kidney transplant at California Pacific in 2003.

Dr. Brian Lee, director of UCSF’s Living Kidney Donation Program, said that while a kidney donation chain could technically go on forever, he said the number should be limited for swaps conducted in one fell swoop.

“One of the downsides of trying to break the latest record and get the most number of people transplanted is that when you have so many logistical issues and so many people involved, it only takes one break in the chain to negatively impact everyone else,” he said.

Victoria Colliver is a San Francisco Chronicle staff writer. E-mail: vcolliver@sfchronicle.com Twitter: @vcolliver

Waiting for kidneys

101,617 people in the U.S. are waiting for a kidney transplant.

18,646 Californians are waiting for a kidney.

5,248 people are waiting for a kidney at UCSF.

1,925 people are waiting for a kidney at California Pacific Medical Center.