Rethinking ‘incompatible’ kidneys for transplant

Rethinking ‘incompatible’ kidneys for transplant

Here’s some good news for the 100,000 people across the country who are awaiting a donor kidney: A study published recently in The New England Journal of Medicine offers evidence of a viable option for people who might otherwise die while seeking a compatible donor.

Researchers at The Johns Hopkins University School of Medicine found that certain kidney transplant patients may live longer if they get a transplant from an incompatible donor rather than waiting for a good match.

The results give hope to so-called “highly sensitized” kidney patients. Those patients have a significant number of immune system antibodies poised to attack a transplanted organ, giving them a reduced chance of receiving a transplant.

Each kidney donor and recipient has a specific combination of proteins, and matching them as closely as possible is the key to transplant success.

Now, researchers have learned that a process called desensitization, which allows a patient to receive a kidney that would otherwise be incompatible, produces lasting results.

When compared with patients who waited and ultimately received a matching kidney from a deceased donor, those who underwent desensitization and got a kidney from a living, non-matching donor also had positive long-term outcomes. Their desensitizing technique was first used 15 years ago, but only now is its long-term benefit becoming clear. Using data from 22 U.S. hospitals, researchers found that more than three-fourths of patients who received a kidney from an incompatible living donor were still alive after eight years.

Researchers say that means an incompatible donor can be a legitimate alternative to waiting for one who is better match.

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