Pure Genius

Previously on Pure Genius...

When I opened Bunker Hill, I made a promise

that I would do everything humanly possible

to save everyone who came through these doors.

- I want to be part of this. - Cheng: So, how's the Malik sitch?

Zoe, I want to go out with you to a concert.

- You know, like on a date. - I'm really sorry, James, but I can't.

Right. Okay.

Hey.

Malik. Hey.

How was your holiday?

Good. Yours?

Oh, it was... great to be back home.

My niece is getting so big.

Anyway, I got to, uh, go get some coffee,

because I am... Totally jetlagged, so...

Okay, so,

this... isn't working for me.

Us not talking about anything.

I know you're not into dating at work. Neither am I.

But I felt something when we were together.

A connection.

I think you did, too.

I like you.

And I want to make a go of this.

Okay.

O-Okay you want to make a go of this or okay you need coffee?

Um...

The first one.

Okay.

No.

- Uh... - Sorry.

We need to get to the Incubator.

Yeah, guys, I don't think we should be watching this.

It's an invasion of privacy.

It is all over the Internet.

It has half a million views.

Bell: Hey, guys.

- James. - Hey.

Cheng: You're back.

How was your vacation?

Lovely.

Uh, nice.

Yours?

- Lovely. - (Stammers) Yeah. Good.

I had a good time. Yeah, good.

Wallace: Everything looks good, constance.

You adapted to the new machine beautifully.

Another 24 hours of observation and we can let you go home.

Any questions?

Uh, just the same one I've been asking all week.

Do we really get to take this machine

back with us to Baltimore?

That's the whole point of the trial; You get the Rolls-Royce

of dialysis in the privacy of your own home.

I-I-I can't believe we're gonna get our freedom back.

Both of us.

Lauren, you have been my angel for two years,

driving me to and from dialysis three days a week.

She never complained.

It hasn't been that bad, mom.

We do what we got to do, right?

Dr. Wallace knows...

Lauren has just had her third callback

for the Paris Opera Ballet.

Isn't that one of the best companies in the world?

The best.

- Wow. - And that's why

this... dialysis machine is a Godsend.

I mean, it's... (Exhales)

It's gonna give me my independence back, and...

Lauren can move to Paris and...

Live her dream.

Whew.

Constance, are you...

Feeling lightheaded? Any dizziness?

Yeah. Maybe. Just a little bit.

Blood pressure's fairly low.

I need to order an EKG and echocardiogram.

There may be, um,

something wrong with your heart.

Bell: Listen up, everyone.

Constance Durand, our kidney patient,

has worsening congestive heart failure.

Heart failure? I thought she just needed dialysis.

It's called cardiorenal syndrome.

It's a known complication in dialysis patients.

Acute kidney injury causes the immune system

to attack the heart.

The damage results in impaired cardiac function.

And the onset, it can be sudden.

Based on her echo,

her left ventricular ejection fraction is 18%.

Yeah, her heart's barely pumping blood,

which means she can't tolerate the lengthy dialysis.

Yeah, and her kidneys are shot. Patients like this don't live

more than a few weeks without a new kidney.

What about a kidney transplant?

Constance has a very rare tissue type.

Her CPRA is 89,

which means she'll reject most kidneys donated

through an organ network.

What about her daughter?

Not a match.

What about a kidney paired donation?

- What's that? - It allows donors

who are incompatible with their loved ones

to switch their kidneys with other donor/recipient pairs.

Yeah. Lauren would donate her kidney to a stranger,

whose loved one would then donate their kidney

to another stranger...

The pattern would repeat itself

until the chain circled back around

and constance would get a compatible kidney.

- Boom. Sounds great. Let's do that. - Yeah, but it's not

gonna be easy building a chain around a sensitized patient

like constance. - She's right. These chains are built

using crude algorithms, designed for single transplant networks.

Which is why we're not gonna rely on

someone else's algorithm; We're gonna build our own.

Of course we are. (Chuckles)

So, what am I looking at?

Each node represents a donor/recipient pair.

Constance and Lauren are the one in the middle.

- Do those lines indicate matches? Yep. - Mm-hmm.

So how long does it take to build a chain?

I'm rendering the algorithm on 4,000 cloud computers,

so what would take 36 hours should prob... Oh, it's done.

Damn it. No matches.

You know, constance has

a very interesting ethnic background.

She's part French

and part ashkenazi.

Tissue type is hereditary.

Patients of similar ethnicities

are more likely to be a match.

We could target people in specific parts of the world...

You want me to expand the algorithm internationally?

Can it be done?

Bonjour. I'd like to request access

to your transplant database.

It's for a kidney paired donation.

In the U.S.

Sure, I'll hold.

Hola. Información del donantes de órganos.

Bunker Hill y James Belll. Sí. Gracias.

I've already spoken to the embassy.

Yes, I know international organ donations are rare.

Guys, I think this is working.

We've got three pairs. Four.

Bell: Five. Six. Seven. Eight.

It's called a kidney paired donation.

We used an algorithm to find

seven other donor/recipient pairs from around the world.

We'd have 'em all fly here

and do the eight transplants at one time.

And this is the only way to save my mom?

This is the only option I see.

I'm sorry. This is a lot.

I... first, you tell me I'm dying,

and now you're telling me that my daughter has

to donate her own kidney to a stranger.

Yes.

But, in return,

a stranger donates a kidney to you.

When would I be able to dance again?

Your recovery would take... Six to eight weeks.

Well, then her answer's no.

- Mom... - no.

The Paris Opera Ballet is like winning

the lottery for a dancer.

Lauren may not get a chance ever again.

I'll do it.

I'll donate my kidney.

Lauren... if it saves my mom,

I'll do it.

Wallace: We have eight patients in dire need of a kidney,

and we have eight donors willing to donate.

But as we know, a kidney chain is extremely delicate.

They are a giant house of cards.

So to avoid potential conflicts, Dr. Wallace and I

have decided to keep all donor/recipient pairs anonymous.

Patients won't know who is donating to whom

until after the surgeries.

Why is pair number seven blank?

Pair number seven agreed to the kidney chain on one condition:

Total anonymity from patients and all Bunker Hill staff.

Get out.

All staff? How is that even possible?

We shut down the east wing on the fifth floor.

Only Dr. Wallace, myself and a select team

will have access to it.

Okay, Dr. Wallace, hand out the assignments.

Listen carefully, everyone.

Dr. channarayapatra,

you'll be in charge of Luisah and Astrid Pierre.

Luisah, born with only one kidney,

suffered a blunt force injury to it

during the 2010 earthquake in Haiti.

Her sister Astrid will be donating on her behalf.