Three-way organ swap ‘opens exciting doors’

A three-way kidney transplant exchange has been carried out in New Zealand for the first time.

The process involved taking three incompatible donor and recipient pairings and matching them with each other to allow a transplant to take place.

The transplants took place in Canterbury and Auckland earlier this month and involved careful planning.

Auckland renal physician Dr Ian Dittmer said while the threeway exchange was ‘‘exciting’’ it was also logistically challenging.

The operations to extract the three kidneys kicked off between 8am and 9am, with the organs on the planes by midday. Once the kidneys arrived at their destinations they were transplanted into the patients and the operations were finished about 7pm.

The transplants were carried out by five surgeons, with about a hundred staff across the two locations.

Christchurch-based National Renal Transplant Service clinical director Dr Nick Cross said they became aware of of the possibility of the three-way exchange a couple of months ago and had been working on setting it up since.

Cross said kidney exchange was particularly demanding for the public health system as it relied on close collaboration between district health boards. It often meant rescheduling to align multiple surgical and medical teams.

In the case of this exchange, two out of three of the kidneys had to be transported by plane. Medical professionals travelled with the organs on commercial flights.

Cross said kidney transplants were the best and most costeffective treatment for people with kidney failure, so a successful

transplant was a win-win for the public health sector.

This particular exchange only cost ‘‘a few thousand more’’ than any other live kidney transplant due to the transport costs.

Health Minister Jonathan Coleman said Kiwis were often keen to help a friend or loved one needing a kidney, but were unable to because of tissue compatibility issues.

The exchange, which was set up about four years ago, is a database of pairs who are not compatible with each other but still want to donate or receive a kidney.

There are about 20 pairs on the New Zealand exchange at any one time. Each time a new pair is added to the exchange, they are checked for compatibility against others on the database.

Kiwi teams carried out two or three two-way exchanges a year.

‘‘Organ transplantation is a lifesaving treatment and for people with organ failure it’s often the only option available,’’ Coleman said.

Dittmer said the first successful three-way exchange opened doors for Kiwis on the kidney exchange list.

Often people on the exchange had been waiting for transplants for a long time, he said.

Hopefully, the success of the three-way exchange would help grow the number of people on the exchange list and lead to further exchanges involving three or more donors.

New Zealand was also working with Australia to set up a transTasman exchange, which could result in up to seven transplant pairs (14 people) being involved in a single exchange.

Dittmer said a lot of good work was being done to increase New Zealand’s organ transplant rate and things were slowly but steadily improving.

A few years ago Auckland was carrying out about 60 transplants a year. This year they hoped to hit 100, he said.

The National Renal Transplant Leadership Team (NRTLT) launched two years ago as a collaboration across district health boards including doctors, surgeons, transplant co-ordinators and administrators.

The Ministry of Health is backing the team in order to increase transplant opportunities for New Zealanders.

The number of kidney transplants (live and deceased) has risen from 118 in 2011, to 147 in 2015.

Christchurch’s Dr Nick Cross said support from the Ministry of Health, transplant teams and the public had helped improve the transplant rate in recent years.

Coleman said great progress was being made on organ donation rates but more could still be done.

Kidney Health New Zealand national education manager Carmel Gregan-Ford said the success of the three-way exchange was fantastic but more donors were needed. - Fairfax NZ The key to being a good speller is not memorising words, it is reading lots of books.

That is the advice from Wellington’s newly crowned champion of TVNZ game show Spellbound, which wound up with Sunday night’s grand final at the Bruce Mason Centre in Auckland.

He won with the word ‘‘ostensible’’. Finn Lewis, 14, a student at Newlands College, said he had never been that interested in being a gun speller until the game show came round.

‘‘I really like reading, but I don’t necessarily want to win a whole lot of spelling competitions.

‘‘It’s mainly just I’m quite good at spelling.’’

Finn has developed a stutter in recent years, making his achievement in front of the television cameras even more impressive.

But he said the stutter did not seem to affect him when spelling.

‘‘You don’t stutter when you sing, because it’s in a different voice, and you’re using your vocal cords in a different way. It’s the same thing with spelling a word, because you’re not saying the words, you are saying the letters.’’

History books had given him the depth of knowledge to acquire the words needed to win a competition such as this, he said.

‘‘But another factor which may have helped was, a couple of times when I’ve been bored, I’ve started to read the dictionary.’’

Lewis had to get through his heat earlier this month to reach the grand final, and estimated he spelled about 30 words to claim the title, not dropping a single one.

He was nearly stumped on one occasion, but that was when his historical knowledge came through.

‘‘The language origin [of the word] can help quite a bit. The dif- ference between a Greek word and a French word, for example, is quite large.’’

The television cameras did not bother him, he said.

‘‘As I got on the stage and started to get into things more, I kind of started to feel a little bit more at home.

‘‘After you’ve talked to the other people in your group backstage, they become more your friends than your rivals.’’

Mum Lynley Lewis said she could not be more proud of Finn’s achievement.

‘‘Six months ago, he was really struggling to string a sentence together.

‘‘For him to be able to stand up on stage and speak, I’m more proud of that than of the spelling achievement.’’

Lewis won a trophy, $5000 towards his studies and $1500 spending money. - Fairfax NZ