Sunday, May 27, 2012

Kidney exchange in San Antonio

Adam Bingaman and his colleagues at the Methodist Specialty and Transplant Hospital,  in San Antonio, Texas, report on their stellar experience with kidney exchange (kidney paired donation). One key to their success is that they enroll compatible as well as incompatible pairs.

A. W. Bingaman, F. H. Wright Jr.M. KapturczakL. ShenS. VickC. L. Murphey, "
Single-Center Kidney Paired Donation: The Methodist San Antonio Experience, American Journal of Transplantation, published online 30 April, 2012

Abstract: Many potential kidney transplant recipients are unable to receive a live donor transplant due to crossmatch or blood type incompatibility. Kidney paired donation increases access to live donor transplantation but has been significantly underutilized. We established a kidney paired donation program including consented incompatible donor/recipient pairs as well as compatible pairs with older non-human leukocyte antigen identical donors. Over a 3-year period, a total of 134 paired donor transplants were performed, including 117 incompatible pairs and 17 compatible pairs. All transplants were done with negative flow cytometry crossmatches and five were done with desensitization combined with paired donation. Kidney paired donation transplants included two-way and three-way exchanges as well as three chains initiated by nondirected donors. Of the sensitized recipients transplanted by paired donation, 44% had calculated panel reactive antibody levels greater than 80%. Transplantation of females and prior transplant recipients was significantly higher with paired donation. Only three episodes of rejection occurred and no transplants were lost due to rejection. These data highlight the potential of kidney paired donation and suggest that all transplant centers should be actively engaged in paired donation to increase access to live donor transplantation.

1 comment:

Nancy said...

How interesting that you would post this article on Sunday, May 27th, the very day that our family arrived here in Rome for my son's Make A Wish trip - a trip that was only able to happen because Samuel is finally well enough to travel and enjoy life after receiving a kidney transplant through a living donor paired exchange at the Texas Transplant Institute in San Antonio.

After a failed first transplant in 2007 at the age of 13, Samuel became highly sensitized and incompatible with 99.99% of the population. So despite having many willing donors, he waited three very difficult years for his second transplant. Through the kindness of Garet Hil at the National Kidney Registry, we were connected with Dr. Bingaman in San Antonio and Samuel was invited to participate in their historic 16-pair exchange in November 2010. We traveled from Vermont to Texas for the transplant and Samuel's sister, Hannah, donated to someone else on Samuel's behalf.

Thank you for discussing great ideas and theories on this blog. Never forget that these ideas have a direct impact on the lives of real people like Samuel! How grateful we are for the work that is being done through the NKR and TTI!

Samuel is enjoying the trip of a lifetime here in Rome! Many, many thanks to the donors and terrific staff and volunteers at the Vermont chapter of Make a Wish!