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New procedure allows kidney transplantation from any donor
Many people around the world are waiting for the transplantation of a new kidney. However, there are also tens of thousands of patients on waiting lists who will probably never receive a new kidney because their immune system would reject the transplanted organ. That could change in the future. Researchers now seem to have found a way in which the immune system of patients also accepts the kidneys from actually incompatible donors.
Physicians at the Johns Hopkins University School of Medicine have now developed a way to change patients' immune systems to accept a transplanted kidney from incompatible donors in a major national study. The revolutionary result was published by scientists in the journal The New England Journal of Medicine.
Revolutionary method allows patients to get a transplanted kidney from a truly incompatible donor. (Image:horizont21 / Fotolia.com)
So-called desensitization can save many lives
The researchers have developed a way that our immune system also accepts the kidneys from truly incompatible donors. The new procedure is called desensitization, explain the doctors. The treatment has the potential to save many lives. It could shorten the waiting time for thousands of people, for some people it would make the difference between a transplant and the rest of their life as a dialysis patient. The procedure can change the lives of many people completely and save them long dialysis times and their unpleasant consequences, emphasize the experts.
Many people have been waiting in vain for a donor animal all their lives
Scientists estimate that about half of the 100,000 people in the United States listed on a kidney transplant list have antibodies that would attack a transplanted organ. Also, about twenty percent of those affected are so sensitive that finding a compatible organ is next to impossible, the researchers explain. An unknown number of patients with kidney failure reject the waiting lists after learning that their bodies reject almost every transplanted organ. Instead, such persons find themselves with a lifelong dialysis. An exhausting and exhausting procedure, which has a very large negative impact on the lives of those affected, says the main author. Dorry Segev of the Johns Hopkins University School of Medicine.
How does a so-called desensitization work??
The so-called desensitization involves first the filtering of the antibodies from the blood of a patient. Patients will then be given an infusion of other antibodies. This provides some protection while the immune system is regenerating its own antibodies, the physicians explain. For some unknown reason, the regenerated antibodies are less invasive to a transplanted organ. If the antibodies continue to be a problem, the patient is treated with drugs that destroy his white blood cells. These can form the antibodies that would attack a new transplanted kidney, the experts explain. By far the largest use of desensitization would be possible in kidney transplants. However, the procedure could also be suitable for liver and lung live donation transplants, the researchers say. The liver is less sensitive to antibodies, so there is less need for desensitization. But such treatment would certainly be possible if it came to incompatibility, Dr. Segev. For lungs, a so-called desensitization is also theoretically possible, although such a treatment has not yet been performed.
Survival probability despite incompatible kidney very good
In the new study, 1,025 patients were examined in 22 medical centers. The subjects had no compatible donors and were compared to patients who had received the organ of a deceased compatible donor. After eight years, 76.5 percent of those who received desensitization and an incompatible kidney were still alive. Compared with 62.9 percent who had been on the waiting list and had received a donor kidney from a deceased person. The value was 43.9 percent, if those affected remained on the waiting list, but never received a transplant, the experts add.
Patients with desensitization need a live donor
The process of desensitization takes time, with some patients it takes about two weeks. Desensitization is performed before transplantation, so patients need a live donor. It is not known how many people are willing to donate a kidney, but the doctors say that they often see situations in which a relative or even a friend is willing to donate his organ, which unfortunately is not compatible. Often, patients must be told that their living donors are not compatible, which is why they are stuck on the waiting list for a deceased donor, Dr. Segev. In recent years, however, there has been another option in some countries - a so-called kidney exchange. Patients who were not compatible with their live donors could exchange these donors with someone whose donor organ was compatible with them. (As)