Kidney transplant procedure makes all donors compatible

22nd March 2016

Enaie Azambuja

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Desensitisation is a technique that prevents rejection of transplanted kidneys, which means that donors and patients can be much more easily matched. A new study of 1,000 patients shows its promise at changing how organ transplants work. Incompatibility between donor and recipient is the biggest barrier to successful transplants. If the recipient’s immune system attacks the organ, then the transplant fails.

Finding a successful match between non-related people is a one in 100,000 chance, according to Popular Science. About 76% of desensitisation patients were still alive after eight years.

Desensitisation works by filtering antibodies from the patient’s blood, which suppresses the immune response against the foreign kidney. During the eight-year study from Johns Hopkins University School of Medicine, patients undergoing desensitisation treatments were pitted against folks who received kidneys from compatible donors, and those who remained on dialysis.

The results were telling: About 76% of desensitisation patients were still alive after eight years compared to 44% of those who stayed on dialysis. The desensitisation process even beat out compatible donations—only 63% of those receiving a compatible organ survived.

This is significant because at any given time there are around 20,000 people waiting for kidneys who are "highly sensitised and for whom finding a compatible donor is nearly impossible," says the study’s lead author Dorry Segev. "That’s a lot of people who could have a better chance at surviving if they are allowed to move forward with incompatible live donor transplantation."

The process has been in experimental use for 15 years, but this is the first nationwide study to assess the benefit to patients. The idea is to push the process into regular use. One barrier to this might be cost. Desensitisation, as an ongoing process, is expensive. But not, crucially, as expensive as dialysis. "Incompatible transplantation is essentially one-tenth of the price of dialysis for a patient stuck on the wait list," Segev says in a news release.

The idea is to push the process into regular use. Also, by essentially making incompatible organs compatible, waiting times can be cut. "During the wait for a compatible organ, the patient gets sicker and sicker. This can become costly—physically, emotionally and financially—for the patient and his or her loved ones," says Segev.

What the study shows is that transplant recipients are twice as likely to survive using desensitisation than with their next best option. Those are convincing numbers, and because they are gathered from multiple facilities across the country, they make a good case for more widespread use of the technique.