I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medical Breakthroughs => Topic started by: hephziba on July 11, 2007, 12:02:14 PM
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I recieved a letter from our local transplant unit in may this year telling us of new advances in transplantation and it reads as follows.
"as many of you know living donor transplanation is possible, in the past however we would never have considered performing a kidney transplant if the potential recipient and donor do not have matching blood types.
however new advances in transplantation mean that it may be possible to carry out a kidney transplant even if the blood types do not match, the transplant program at guys hospital have introduced a program and in the last year have succesfully performed 5 transplants where there was a different blood type between donor and recipient, in the past this was impossible , we are writing to tell you it may now be possible.
we would like to emphesis that it is not suitable for all patients. if you are interested and would like to explore the possibilities further please contact...
fyi
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OH WOW! Is this for real?
I'd love to give Wade a kidney, but he's B+ and im A-. UGH!
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OH WOW! Is this for real?
I'd love to give Wade a kidney, but he's B+ and im A-. UGH!
Not too sure if this is valid in the states, Hephzibia is from the U.K. but it sure would be nice wouldn't it :clap;
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What better reason for a vacation? :D
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I thought I had heard of this being a possibility here in the states. I've been known to be wrong a time or two. ;)
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This is a great new for kidney patients.
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These ABO in-compatible transplants are not done by all hospitals. Mayo has been doing them since 2000. Here's one woman's experience: http://www.mayoclinic.org/kidney-transplant/bobbiebartz.html
From Mayo's website:
ABO Incompatible Kidney Transplant
ABO incompatibility refers to the immune reaction that occurs when different blood types are mixed together. The presence or lack of molecules on the surface of the blood cells defines your blood type. Type O has no molecules. Types A and B each have a combination of two molecules, which result in type A (AA or AO molecules), type B (BB or BO molecules), or type AB. When blood types are mixed, the molecules act as antigens that trigger an ABO incompatibility reaction. That's why blood types must be matched.
Dr. Stegall's multidisciplinary team included transplant nephrologist James Gloor, M.D., transplantation biologist Jeffrey Platt, Ph.D., histo(blood)compatibility expert Breanndan Moore, M.D., renal pathologist Donna Lager, M.D. and Alvaro Pineda, M.D., who directed Mayo's apheresis laboratory.
"We modified the Japanese protocol for ABO incompatibility kidney transplants and began performing them in May, 1999," says Dr. Gloor. "Our success rates almost equaled those performed with blood-type-compatible recipients."
The type of preconditioning done to cleanse the blood of antibodies depends on the patient's blood type and the amount of antibodies present. In general, it involves some combination of the following therapies before transplantation:
* Plasmapheresis — to physically remove antibodies.
* Immunoglobulin — also called gamma globulin, which appears to decrease antibody activity destructive to the graft. The mechanism is poorly understood since gamma globulin are themselves antibodies that disarm foreign antigens by binding to them.
* Splenectomy — the spleen concentrates B lymphocytes around its blood vessels to fight infection so removing it in a person with very high levels of antibodies wards off graft rejection.
* Anti-CD20 antibody (rituximab) — depletes the CD20 protein, which is found on the wall of most B cells.
Recipient antibodies are monitored during the first two weeks following transplantation and treated by plasmapheresis if they rise above a predetermined level. Like all transplant recipients, the patients must remain on drugs that suppress the immune system, such as thymoglobulin, tacrolimus, mycophenolate mofetil, and prednisone, for as long as the grafted kidney survives.