A nationwide study has found that using incompatible kidneys in transplants is better than doing no transplant at all. Patients waiting for kidney transplants often never find a donor because they're told their bodies will reject organs that don't match their immune system. Instead, they may have to spend the rest of their lives on dialysis, an exhausting procedure that has to be undertaken several days a week, hours at a time. This new research, though, suggests that holding out for a perfect match isn't necessary.
Researchers described the findings as "revolutionary"
The study, published in The New England Journal of Medicine, looked at the survival rates for 1,025 patients receiving incompatible kidneys from live donors, comparing them with other kidney transplant patients. After eight years, 76.5 percent of the individuals receiving incompatible kidneys from live donors were still alive — a better outlook than for patients who stayed on the waiting list or got an incompatible kidney from a deceased donor (62.9 percent survival rate), or for patients who never received a transplant at all (43.9 percent). An accompanying editorial in the New England journal described the findings as "revolutionary."
There is a caveat, though: patients' immune systems have to be "desensitized" before they can receive an incompatible kidney transplant. This means filtering antibodies that reject foreign organs out of their bodies and letting these antibodies regenerate again, a process that is costly and has its own dangers, including increased risk of infection. This procedure also places a time limit on the transplant, meaning that patients need living donors.
"compared to the cost of a transplant, it's relatively low."
Depending on the patient's antibody levels, the desensitization process "can take a few days to a couple of weeks," the paper's senior author, Dorry Segev, told Reuters Health. "But compared to the cost of a transplant, it's relatively low. If a transplant costs perhaps $100,000 and you add desensitization, it might be $110,000 to $120,000." This is less expensive than dialysis, though, which can cost as much as $100,000 a year.
Speaking to The New York Times, researchers involved in the study said that the desensitization process might also be suitable for liver and lung transplants, although little to no research has been carried out in this area. For the moment, though, the study has clear implications for those awaiting kidney transplants. "We used to say if you had a compatible donor, you could do a transplant," Segev told Reuters Health. "Now you can say, if you have an incompatible donor, we still can make that transplant happen... That's very exciting to those on the waiting list."