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Kidney Diplomacy Offers Hope to Patients Worldwide

The Alliance for Paired Kidney Donation (APKD), a global leader in kidney donation, successfully facilitated a three-way kidney exchange between donors and patients from the United Arab Emirates and Israel that saved the lives of three women.

Michael Rees, MD, Ph.D.

CEO, Alliance for Paired Kidney Donation

The procedures, the first ever between Israel and the UAE, were the result of a collaboration between the APKD, the UAE Organ Donation and Transplant Committee, and the Israel Center for Transplantation.

The complicated exchange involved three kidney patients, two from Israel and one from the UAE, in a “pay-it-forward” series of transplants that required six surgeries and four hospitals. Each patient had a willing, living donor whose kidney was not a match for them but did match another patient.

Paying it forward

The three-way exchange worked like this: An Abu Dhabi-based donor gave a kidney to a patient from Israel whose husband did not match her. The husband donated one of his kidneys to a patient at another hospital in Israel, and in turn that patient’s incompatible donor, her daughter, donated her kidney, where it was transplanted into the original UAE donor’s mother. A private jet flew the Israeli daughter’s kidney across Saudi Arabia on a four-hour flight; 30 minutes later, the same plane flew the UAE daughter’s kidney back across Saudi Arabia to save the life of an Israeli mother.

As a result of this “kidney diplomacy,” which crossed religious and ideological lines, three lives were saved, valuable relationships were formed, and new transplantation regulations were developed. This exchange demonstrates how we can harness our differences for mutual benefit.

A global solution

In addition to working with governments, healthcare providers, and payers around the world to setup systems and processes that support paired kidney donation, APKD provides an industry-leading global kidney registry powered by the Nobel prize-winning algorithm of Dr. Alvin Roth of Stanford University. Dr. Roth has repeatedly stated publicly that we need a global solution to the global problem of kidney disease. Kidney exchange across borders creates a larger, more diverse pool of patients and donors resulting in more compatible matches.

Kidney disease is a leading cause of death around the world. While dialysis helps, kidney transplantation is the only cure once the kidney has failed. Kidney failure patients often have donors willing to help, only to learn the patient and donor are incompatible, ruling out the possibility of a transplant. This was the case for each of the patients involved — two women with daughters who did not match and one woman whose husband was not a match. Kidney exchanges make transplantation possible, because they allow incompatible pairs to exchange their donor’s kidney, resulting in each patient in need receiving a compatible kidney.

Bridging gaps

To make this exchange possible, APKD’s Chief Growth Officer Atul Agnihotri worked for months behind the scenes. UAE and Israel recognized how collaborating on this exchange would save lives, and all parties understood the magnitude of this event. This was more than a three-way exchange; it was a statement about our collective humanity. As Dr. Roth notes, “This exchange can bring not only health, but peace.”

The APKD was created to lead innovation in the living donor kidney space. As a result of this exchange, three lives were saved, new transplantation regulations were developed, and valuable relationships were formed.  

We are honored to work with transplant centers around the world, and we hope kidney transplantation can not only help save lives, but also help bridge gaps and improve dialogue between countries.

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