Encouraging Living Donations
The following is an article featured on the Johns Hopkins University website.
Encouraging the living donor trend is the latest breakthrough in kidney transplantation. The transplant team at Johns Hopkins has pioneered several innovations that now make it possible for any patient with renal failure to receive a kidney from any donor, regardless of his or her blood or tissue type.
Patients whose blood or tissue types are incompatible with their donors undergo plasmapheresis, which is similar to dialysis. The procedure removes the plasma portion of the blood, where harmful antibodies are located. After each plasmapheresis, the recipient receives an intravenous infusion of immune globulin to replace antibodies needed to fight infections and help prevent harmful antibodies from returning. To increase the chances of success, the recipient requires additional immunosuppressive medication and may need additional plasmapheresis treatments and a kidney biopsy.
Although the procedure is in its infancy, successful outcomes have been the norm, according to Robert Montgomery, M.D., PhD, and Assistant Professor of Surgery, who spearheads the program at Hopkins.
The results are comparable to those achieved with compatible kidney transplants. Worldwide, 82 percent of blood type incompatible kidney transplants are working one year after transplant and 78 percent are functioning 5 years post-transplant.
“This procedure has eliminated the barrier that has kept thousands of patients from receiving a life-saving transplant,” says Dr. Montgomery. Of the roughly 12,000 kidneys transplanted in the U.S. annually, about 5,000 are from live donors, but one-third of the recipients are not good matches with these potential donors, either because their blood types are incompatible or because they have developed antibodies against donor tissue. This can happen because of previous transplants, blood transfusions or pregnancies.