State first kidney transplant for incompatible blood type
During Kidney Health Week, 27 May – 2 June, the Newcastle Transplant Unit has announced the successful transplantation of a kidney from a live donor whose blood group is A into a patient whose blood group is O.
Dr Paul Trevillian, Staff Transplant Physician at John Hunter Hospital said this has defied the conventional rules of transplantation, which say the kidney should be immediately lost by a process called “hyper-acute rejection”.
“By using a “desensitisation” protocol, the recipient’s blood was cleared of the offending blood group antibodies beforehand to make it safe to proceed.
“This technique involved the use of “adsorption columns”, specially imported from Sweden, which selectively remove the antibodies as the recipients’ blood is pumped through the columns. This treatment is an advance on the previously used technique of “plasma exchange” as it leaves the rest of the patients’ immunity intact,” Dr Trevillian said.
The donor recipient is Mr Charles Hodges a 70-year-old retired former Detective Chief Superintendent of NSW Police who has had renal failure for over 30 years. Before the transplant, he was dependant on multiple, weekly haemodialysis treatments to survive.
Mr Hodges had already had a failed kidney transplant due to chronic rejection and as a result was “highly sensitised” to other peoples’ tissues. He had virtually given up hope of ever receiving another kidney transplant.
His wife of 49 years, Mrs Janet Hodges was able to donate one of her kidney although their blood type did not match.
“I was always a willing donor but until recently we believed I could never provide a kidney because of the blood group incompatibility,” Janet said.
It is now two months since their successful transplant and Mr Hodges has never been so well.
“The last time I had kidney function this good I was a teenager,” Mr Hodges said.
In 1999, the Newcastle Transplant Unit was the first Transplant Unit in Australia to perform a kidney transplant from a live donor into a highly sensitised recipient with a positive cross match.
“Our success with the highly sensitised recipient program has given us the skills and confidence to tackle ABO incompatible transplants because we now have the tools to reverse antibody mediated rejection, the most feared form of transplant rejection,” said Dr Trevillian.
“Who would have thought 20 years ago that we would be transplanting kidneys between living, unrelated, highly sensitised and ABO incompatible donor recipients, as is the case here,” Dr Trevillian said.
The technique is now well established in specialised centres particularly in Japan, Sweden and the USA. Last year, Royal Melbourne Hospital became the first Transplant Unit in Australia to perform an ABO Incompatible transplant.
Professor Hibberd, Area Director of Transplantation at John Hunter Hospital said the shortage of deceased organ donors in Australia has necessitated innovative approaches to live donor transplantation, and Newcastle is at the forefront of these developments.
“To be able to safely transplant from ABO incompatible donors has the potential to expand the numbers of transplants in this region by 20-30 per cent,” Professor Hibberd said.
“This has enormous cost benefits to the health system as well as giving our patients improved well being and longevity,” Professor Hibberd said.
Contact: Nerida Walker
Phone: 4921 4477 or 0428 107 681