New Method For Kidney Transplant Could Greatly Extend The Lives Of Patients

In the United States alone, more than 100,000 people are on the national waiting list for a kidney transplant. However, last year only 17,878 transplants were performed, the Associated Press reported, citing information from the United Network for Organ Sharing. Tens of thousands of people are still waiting for a kidney that is compatible, and nearly one-in-three patients who need a kidney transplant are especially hard to match. But for many of these patients, finding an organ is especially difficult because their immune systems tend to reject most transplanted organs.

Nearly 30 percent of people waiting for a kidney are considered “sensitized,” (i.e have an exceptionally high level of antibodies that react to rejecting foreign tissue), making it extremely difficult to find a donor. The production of these antibodies can be caused by pregnancy, blood transfusion, or a previous transplant.

According to the New York Times, these patients now have good news because a new method for kidney transplants could revolutionize the procedure. Experts say a new procedure called “desensitization” has allowed doctors to alter patients’ immune systems and give them kidneys from living donors who were previously considered incompatible. Desensitization involves filtering the patient’s blood to remove antibodies that would attack the donated kidney

“Desensitization is still not for every transplant center,” the study’s senior author, Dr. Dorry Segev of Johns Hopkins University, explained. “But the findings show you don’t need a compatible living donor to make a transplant happen today — you just need a living donor.”

Major impact of #ABO desensitization on #infection control after #kidney #transplantation http://t.co/A6FiRlYUO8 pic.twitter.com/JmWLFWPOtu

— Transplant International (@Transpl_Int) September 17, 2015

The findings of the study were recently published in The New England Journal of Medicine, and the results showed that doctors were able to successfully alter patients’ immune systems to allow them to accept kidneys from incompatible donors. The method, which doctors believe will save many lives, extended the lives of those patients by eight years more than patients who had remained on waiting lists or received a kidney transplant from a deceased donor.

The study validated single-center evidence that patients who received kidney transplants from HLA-incompatible live donors had a substantial survival benefit as compared with patients who did not undergo transplantation and those who waited for transplants from deceased donors. The study was conducted at 22 medical centers with 1,025 patients receiving kidney transplants and who were followed for eight years.

Experts described the study as “revolutionary” and claim that this could open the door to carry out the procedure with other organs such as livers or lungs.

“We used to say if you had a compatible donor, you could do a transplant. Now you can say, if you have an incompatible donor, we still can make that transplant happen,” Segev told Reuters Health. “That’s very exciting to those on the waiting list.”

The results showed that after eight years, the survival rate of the 1,025 sensitized patients receiving incompatible kidneys was 77 percent, compared with 63 percent of those receiving a kidney from a dead donor, and 44 percent of those who were on the waiting list.

“The paper is showing how much longer the patient will live compared to their next available option,” Segev adds. “Your next best option is waiting on the list for a compatible donor, and a lot of those patients will never find one.”

However, desensitization has two problems: the patient must be submitted to transplantation immediately after the procedure, because if you have to wait, the body can re-form antibodies. And the process is also costly; between $10,000 and $20,000, plus $100,000, which is the average cost of a transplant.

However, as explained by Dr. Segev, if compared to $100,000 a year for dialysis, long-term transplantation becomes cost effective.

[Image via Christopher Furlong/Getty Images News]