Kidney and bladder health

Updated 04 July 2018

6 people take part in rare 3-way kidney transplant

This three-way transplant worked with three couples, each with one person who needed a transplant.

Imagine the following scenario: David Labocki needed a kidney. His wife Danae was unfortunately not a suitable donor.

At the same time Nancy Botbyl would have died if she did not get a new kidney, and like David's spouse, her husband, Gregg was not a suitable donor.

Now add two anonymous friends: One who needs a kidney, and the other one who is not a match for his friend. What to do? 

Doctors from the Cleveland Clinic found a way to involve all six people and save the lives of David, Nancy and the anonymous friend. They performed a rare three-way kidney transplant, also referred to as a "kidney swap". 

kidney transplant, 3-way kidney transplant
  • David (who had a transplant seven years ago, but his body started to reject that kidney) received one from the anonymous friend of the anonymous person also seeking a kidney. 
  • Nancy (who was diagnosed with polycystic kidney disease, a genetic condition that could lead to kidney failure) received a new kidney from David's wife, Danae.
  • And finally the anonymous person who was in need of a new kidney received one from Gregg, Nancy's husband. 

The need

According a 2014 study, many potential kidney recipients can't receive a kidney from their loved ones as they are incompatible. Kidney Paired Donation (KPD), the technical term for this three-way transplant, is often considered a viable way to get more people involved in donation. 

"In an era of organ shortage, this approach is relevant to encourage wider participation from KPD donors and transplant centres to prevent commercial transplantation," the study found. 

"Encouraging the use of this approach to expand the donor pool would be important, especially in low-income countries where the deceased donor programme is in an infantile stage."

kidney transplant, 3-way kidney transplant

                                                                             Nancy and her husband Gregg


Dr Alvin Wee, surgical director of the Renal Transplantation Programme at Cleveland Clinic, told the Daily Mail that the logistics of arranging such a procedure is complicated. 

"All six members have to agree to have surgery on the same day or over the course of a couple of days.

"The second issue is finding the match. It seems easy once you have all six people, but organising it is hard."

The transplantations were organised by the National Kidney Registry in the UK. This non-profit organisation aims to speed transplants by pairing up donors and recipients resulting in two- or three-way swaps.

kidney transplant, 3-way kidney transplant

                                                                       Nancy after the procedure.

There is hope

In the meantime, Dr Wee hopes the procedure will open people's eyes.

"Just because one donor is not compatible with you does not mean the end of the line for you.

"There are heroes out there that who are willing to go above and beyond for you. And it really shows the goodness of their hearts to help three people their friend or spouse and people they've never even met before."

Image credits: iStock, Tabitha Renee Photography - via Cleveland Clinic