EMERGING TECHNOLOGIES
Match brings hope
Twenty-three successful living donor kidney transplants in the past two years are proof that Matchmaker is a life-changing innovation. David Jacobs, founder of Silverstone Solutions, was spurred into creating Matchmaker computer software after he needed a replacement kidney. The software can tell doctors within minutes if a patient requiring kidney replacement can be matched from others in a living donor pool.
Jacobs received a replacement kidney after spending three-and-a-half years on the deceased donor recipient list. His brother wasn’t so fortunate and died without a transplant.
One of the biggest hindrances to matching donors and recipients is not having a real-time tool to determine the best option. Jacobs says about one-third of potential living donors – often patients’ relatives – are not suitable matches, but could be a match for another transplant patient in the same situation.
“I looked at the problem and realized I could make an impact on it,” says Jacobs, who previously spent two decades developing fledgling software companies. “It was born out of my frustration of waiting and seeing no options available to me.”
Matchmaker was piloted in San Francisco’s California Pacific Medical Center (CPMC), with efforts to find donors for the hardest-to-match recipients. By spring 2009, its Matchmaker transplant pool had 250 recipient-donor pairs from 2,000 potential kidney recipients on the CPMC waiting list. Each time a paired donor match is identified, two or more recipients receive kidneys in simultaneous surgeries – reducing the number awaiting transplant by at least two.
“For the patients, it’s great; it takes people who otherwise aren’t transplantable and gives them an option,” says Steve Katznelson, a transplant nephrologist. And completing a living donor transplant frees up a deceased donor kidney for another patient.
Matching suitable donor kidneys to recipients is highly complex, and comparing multiple donors to determine the most suitable to receive each organ is practically impossible for a human. Almost 80,000 U.S. residents needing a kidney transplant are registered with the U.S. Department of Health and Human Services. More than 7,400 Texans are on that list.
Katznelson says the impact on patients and society at large is highly significant: patients needing a transplant usually are receiving dialysis and are prone to life-threatening illnesses. After surgery, they are off dialysis and off the transplant list.
Developments since Matchmaker launched include tools that will convert a hospital’s data to a suitable format for the software to analyze and screens that visualize the huge volume of data a doctor needs to determine a donor-recipient match’s suitability. The software includes optimization technology to guide doctors as they select the best candidates for transplant among all suitable matches.
“I’ve never done anything more meaningful,” Jacobs says. “To pull this off was an algorithmic computing challenge. With the algorithm, the computer can do 2 million combinations in 10 minutes.”
Matchmaker is a proven success, Jacobs says, and soon will be available to other hospitals.
If the pool of living donor pairs is increased, the potential for suitable matches will grow exponentially. Katznelson says that could be 200 to 250 additional transplants in the Western states and up to 3,000 annually across the nation.
For more information, email Silverstone or visit the Silverstone Solutions website.
ENVIRONMENTAL SCIENCE
Clean-burning garbage trucks
The city of San Antonio has a new fleet of compressed natural gas (CNG) garbage trucks.
Aided by federal and state grants, the city purchased 30 CNG-powered trucks in September 2008, says Salvador Ytuarte, district manager for the Northeast service center in San Antonio.
“We were looking to try and clean up the city,” Ytuarte says.
CNG garbage trucks cost about $32,000 more than diesel trucks, but the city saves about 70 cents per gallon in fuel costs.
City officials are awaiting results from a survey by Texas A&M University on whether the new trucks have helped improve the city’s environment.
For more information, contact San Antonio’s Solid Waste Management Department, (210) 207-6428.