Steve Ruark/Associated Press
	Tracy Stahl, left, of Johnstown, and her sister Connie Dick of Latrobe laugh during a news conference yesterday at Johns Hopkins Hospital in Baltimore. Stahl received a kidney from Julia Tower of Hyattsville, Md. and Dick donated a kidney to Germaine Allum of Coral Gables, Fla., in what is thought to be the world's first "triple swap" kidney transplant.

In what is thought to be the world's first "triple swap" kidney transplant operation, three people who'd never previously met donated their kidneys this week to one another's sister, family friend and fiancee.

Each person had volunteered to give a kidney to a loved one, but none proved to be compatible for transplant. Doctors at Johns Hopkins Comprehensive Transplant Center in Baltimore, where the transplants were to take place, realized, however, that all of their patients could still end up getting a transplant if the donors would be willing to donate to someone else.

So Tracy Stahl, 39, of Johnstown, who had hoped to receive a kidney from her 41-year-old sister, Connie Dick of Latrobe, ended up with the kidney of a stranger, Julia Tower, 56, of Hyattsville, Md.

And Dick gave her kidney to Germaine Allum, 30, of Coral Gables, Fla., who had anticipated receiving a kidney from her fiance, Paul Boissiere, also 30.

Boissiere's kidney was transplanted into 13-year-old Jeremy Weiser-Warschoff of Hyattsville, Md., the son of a friend of Tower.

	Keith Weller/Johns Hopkins Medical Institutions
	Connie Dick, of Latrobe, left, donated a kidney to Germaine Allum of Coral Gables, Florida, in what is believed to be the world's first "triple swap" kidney transplant operation at Johns Hopkins Hospital in Baltimore.

The operations were performed simultaneously on Monday by six teams of two surgeons, two anesthesiologists and two nurses. Allum and Weiser-Warschoff are still recovering in the hospital, but the other four were discharged yesterday, said surgeon Dr. Robert Montgomery, director of Hopkins' incompatible kidney transplant program.

"All three of the donors just wanted to see their recipients get a kidney," he said. "They knew that they were in sort of desperate straits."

It wasn't until after the operations were over that each patient was asked if they wanted to meet the others in the swap. With smiles and tears, Stahl said, they greeted each other for the first time shortly before a news conference yesterday.

"We were all anxious to meet each other," she said. "It's like an extended family for us."

For Stahl, finding a suitable donor organ verged on miraculous. She and her sister both had Type B blood, but Stahl carried antibodies that would attack Dick's kidney. She had already undergone a procedure in Pittsburgh that attempts to strip some of the immune proteins out of the blood, but it didn't work.

	Keith Weller/Johns Hopkins Medical Institutions
	Kidney donor Julia Tower, left, visits with recipient Tracy Stahl of Johnstown at Johns Hopkins Hospital in Baltimore.

"She had pretty much given up on the possibility of transplant," Montgomery said. He added that her family encouraged her to keep looking for help, and Stahl and her sister went to Hopkins as a last resort.

Doctors suspected that her immune system was so sensitive, she'd immediately reject a donor organ from almost anyone. The chance of finding a suitable organ was one in a million.

That unique kidney belonged to Tower. The women matched on five out of six tissue factors and Stahl didn't have antibodies to Tower's sixth factor.

"It was very unusual," Montgomery said. "That was the swap that really was the cornerstone of the whole thing."

Through the center's paired kidney exchange transplant program, Hopkins surgeons have swapped organs between two pairs of donor-recipients four times since 2001. This is the first time kidneys have been exchanged among six people.

Doctors lauded the generosity and flexibility of the donors, who gave their organs to strangers.

As the patients themselves noted, Montgomery said, "it was wonderful that they actually enabled three transplants rather than just one."

	Keith Weller/Johns Hopkins Medical Institutions
	Tracy Stahl, left, of Johnstown and her sister Connie Dick, of Latrobe, at Johns Hopkins Hospital in Baltimore, where they participated in a triple swap transplant operation that allowed three patients who were not compatible with their kidney donors to exchange their donor's kidney for a kidney from a more compatible donor.

Up to 30 percent of the 55,000 people who are waiting for kidney transplants carry antibodies that make it difficult to find an acceptable match, Montgomery said. Women are disproportionately affected because they can develop antibodies during pregnancy. Blood transfusions can also lead to antibody formation.

He added that a third of donor-recipient pairs were turned down because of blood group incompatibility before the "swap program" was put in place. It's a way to increase the chances of finding willing donors for kidney transplant patients.

After five years of dialysis, Stahl is now going to the bathroom again.

"It's great," she said, laughing. "I've been up a lot during the night, but I'm not complaining about it."