New Procedure Allows More Successful Kidney Transplantation

A new procedure called desensitization allows doctors to alter patient’s immune systems and transplant kidneys from living donors previously considered incompatible. Experts say that this method could revolutionize kidney transplants and help save millions of people.

Patients who received such kidneys after desensitization in a large study were found to live for eight years more than those who were on dialysis or those on the waiting list.

Paired Donor Exchange Kidney Transplantation
Paired donor exchange kidney transplantation is a process in which unrelated kidney donors are matched to recipients so that compatible transplants can be performed.

‘The procedure called desensitization altered patients’ immune systems to allow them to accept kidneys from incompatible donors.’

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The method, known as desensitization, “has the potential to save many lives,” said Dr. Jeffery Berns, a kidney specialist at the University of Pennsylvania’s Perelman School of Medicine and the president of the National Kidney Foundation .

"We used to say if you had a compatible donor, you could do a transplant. Now you can say, if you have an incompatible donor, we still can make that transplant happen," said senior study author Dr. Dorry Segev of John Hopkins University.

"That's very exciting to those on the waiting list."

National Underutilization of Pre-Emptive, Early Kidney Transplants
80% of kidney transplants at Mayo Clinic in the past 15 years have been from living donors, with 40% of those being pre-emptive living donor transplants.

The chances of rejection remain higher with the "incompatible" kidneys, but the research shows that getting a new organ quickly outweighs the benefits of spending years on dialysis or waiting for a compatible one.

Desensitization is a procedure that filters the antibodies out of the patient’s blood, and then offers an infusion of other antibodies for protective action, while the immune system is regenerating its own antibodies.

Racial Disparities Reduced in Kidney Transplant Recipients
Black kidney transplant recipients tend to experience poorer outcomes-such as kidney rejection and premature death-compared with white kidney recipients.

Drugs are provided to destroy white blood cells that prompt the antibodies to attack the kidney.

The desensitization procedure can cost up to $20,000 for the procedure and thousands more for the drugs. However, it is cost-effective when compared to $100,000 a year for dialysis.

National Under-Utilization of Preemptive and Early Kidney Transplants
Only one-third of patients who ultimately receive a living donor kidney transplant receive it pre-emptively i.e. before starting dialysis.

The study is published in the New England Journal of Medicine.

Source-Medindia