It's better to give and receive in kidney transplant shuffle

It's better to give and receive in kidney transplant shuffle
Date
August 23, 2012

Julie Robotham

Kidney Transplant www.TransplantExperience.com
Understanding Kidney Transplants Information and Advice for Patients

SUE HARMER lay in a Melbourne hospital bed after having her kidney removed. Down the corridor her sister Di Abrahams was recovering after receiving a transplanted kidney.

But this was not a simple donation. Mrs Harmer's kidney was incompatible with her sister's body, sensitised by a previous transplant and the multiple blood transfusions Mrs Abrahams, 55, had received as a young woman after a genetic disorder disabled her kidneys.

So 58-year-old Mrs Harmer's kidney travelled interstate on a courier flight, destined for another recipient whose relative or friend in turn donated a kidney in a swap to match compatible organs between incompatible donor and recipient pairs.

''It's mind blowing,'' said Mrs Abrahams this week. ''Your loved one wants you to be well again, so everyone gets what they want. It doesn't matter to me that it wasn't Sue's organ. Without her it still wouldn't have happened.''

Advertisement
It was a happier experience than her original transplant, from a deceased donor, said Mrs Abrahams. ''It stops that grief you feel for a family that's going through a terrible time,'' she said. ''Every anniversary I thought about that poor family.''

Mrs Harmer, now fully convalesced, was pleased to be told the physical recipient is doing well but said, ''I focused on Di. I considered that Di was my recipient and I didn't give much thought to [the other person]. I so wanted my sister to be well again.''

In a further twist, the sisters' kidney shuffle may not have ended there. Three-way and four-way exchanges - in which multiple spouses, siblings, parents, children or close friends donate to each others' intended recipients and must all be anaesthetised and operated on simultaneously - make up a growing proportion of transplants through the Australian Paired Kidney Exchange program, which runs through the federal government agency DonateLife and has so far provided 31 transplants.

Stephen McDonald, executive officer at the ANZDATA project, which collects and analyses kidney failure and treatment statistics, said advances during the 1990s had allowed kidneys to be transplanted across blood groups and tissue types, making transplants possible from unrelated donors. But the figures show live donations peaked in Australia in 2008 with 354 donations, and have since fallen by almost 20 per cent.

''We are trying to work out why that is,'' said Professor McDonald, an Adelaide specialist. ''It's not necessarily that people are becoming less generous. We may be getting some people through the system who previously couldn't be transplanted,'' reducing a backlog in willing donors.

People with high antibody levels and women sensitised by multiple pregnancies were unlikely to be allocated suitable organs from the deceased donor pool, for which close compatibility was a major determinant.

Paired exchanges for those with a willing but incompatible donor therefore ''provide access to transplantation to people who would not otherwise be able to do it'', Professor McDonald said. The procedures were a difficult logistical exercise, he said, but they had to be performed simultaneously. ''That's your ticket in the game,'' he said. ''You don't want to lose your donor without getting a kidney back.''

Read more: http://www.smh.com.au/national/its-better-to-give-and-receive-in-kidney-transplant-shuffle-20120822-24mvx.html#ixzz24MYdY7Ki