Getting her body to accept his kidney

[okarol]

Getting her body to accept his kidney

By Judith Tan
Oct 12, 2009

HOUSEWIFE Daisy Goh's kidneys were failing, but the only kidney available was from her husband, who had a different blood type.

On top of that, she had a hyperactive immune system which would attack and destroy donor tissue.

But a team of doctors from the National University Hospital (NUH) overcame the two challenges, giving the 35-year-old a working kidney, and a new lease of life.

They did this through new technology which lowered the antibodies in her blood, combined with immunosuppressant drugs.

The Sept 17 surgery is believed to be the first such transplant in Singapore, and one of only 40 done worldwide.

Madam Goh's kidneys had been failing for 13 years because of lupus, an autoimmune disease where the body's immune system turns on itself, attacking healthy tissue.

Her husband, driver Thung Toh Khee, 43, was the only donor available, although his blood group was B, while Madam Goh's was O.

Said Professor A. Vathsala, director of the hospital's kidney transplant programme: "In the nearly 60 years of transplantation history, transplants across such incompatible groups were doomed to failure."

But a new device developed in Sweden has recently surfaced to overcome this problem - the Immunoadsorption Column, which removes the patient's blood group antibodies, which would otherwise attack the new organ.

To remove the antibodies, all of Madam Goh's blood was run through the device multiple times. Doctors then dampened her hyperactive immune system with immunosuppression drugs.

There were other challenges too.

Mr Thung, towering over his petite wife, had a much bigger kidney and attaching blood vessels, and surgeons had to be especially careful when stitching them to his wife's smaller ones.

But Madam Goh's new kidney began to work almost immediately.

"We were overjoyed when it produced the first spray of urine," Prof Vathsala said.

But the procedure did not come cheap.

The transplant costs between $80,000 and $100,000, but there is a government subsidy of about 50 per cent. On top of this is an additional $35,000 for the immunoadsorption columns.

Medical social workers from both Tan Tock Seng Hospital - where she had dialysis - and NUH are working with the couple to work out the payment.

The latest technique could provide a new alternative for patients in Singapore, where kidney failure rates are high, say doctors.

Over 700 new patients start dialysis here each year while about 85 people go through a kidney transplant.

As for Madam Goh, who will be discharged next week, she is looking forward to her first taste of durian and other foods, which were struck off her diet during her years of dialysis.

"I cannot wait to eat durian. That is the first thing I'll eat when I get out of here. Also banana and milk. Yum. These were the foods I was not allowed to eat."

juditht@sph.com.sg

http://www.asiaone.com/Health/Women%2527s+Matters/Story/A1Story20091012-173258.html