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Kidney Transplant

Incompatible Donor Kidney Transplant

Innovative ways to increase living-donor transplants

To increase the availability of kidneys from living donors for transplant, Barnes-Jewish Hospital offers innovative programs including ABO or blood type incompatible (ABOi) transplant and tissue type (HLA) incompatible transplant. These two programs allow patients to receive a transplant with a donated kidney that is not an ideal “match” for the patient’s blood or tissue type.


ABO Incompatible Transplant

In order to be considered a candidate for ABOi transplantation, a patient must be a willing and otherwise healthy living donor candidate with a blood type that does not match the patient’s blood type (incompatible blood type). Transplant candidates must also meet the following conditions:
  • End-stage renal failure
  • An acceptable baseline antibody titer
With an ABOi kidney transplant, a kidney failure patient receives a kidney from a living donor with a different blood type. The potential recipient undergoes a “desensitization” procedure (a combination of medications and plasma pheresis treatments) prior to the transplant to decrease the chances their body will reject the donor kidney.

Why do an incompatible transplant?

Currently, there are more than 83,000 Americans on the waiting list for a deceased donor kidney. The waiting time for patients with blood group O or B is approximately five years at most transplant centers. The increasing gap between potential recipients and available deceased donor organs means that the average time on the transplant waiting list exceeds the life expectancy on dialysis for some patients.


HLA Incompatible Transplant

Some kidney transplant candidates have a willing kidney donor, but have strong antibodies (the cells that fight off germs or foreign tissues) in their blood against the donor. This is called HLA incompatibility or a positive crossmatch. These potential recipients can undergo a desensitization procedure similar to the one used with ABOi transplant patients.


Outcomes

Initially, patients having ABOi or HLA incompatible transplants have a slightly higher risk of acute rejection and potential loss of the donor kidney. However, current data suggests that in ABOi transplants, there is no significant difference in long term patient or graft survival
For additional information or to begin a transplant evaluation, call .

Heart/Kidney Transplant

In 2010, Jonathan Sadowski became the first patient at Barnes-Jewish to receive a combined heart/kidney transplant, a new procedure allowing some patients after heart transplant to avoid dialysis.

 

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