If a doctor needs to choose between a transplanting a mismatched kidney and not doing the transplant at all, it’s better to do the procedure. At least, that’s what a new study discovered, saying the finding could open the door to more life-saving operations.
John Hopkins University researchers revealed that patients who received incompatible kidney transplants – because of the anti-HLA antibodies – had more chances of being alive eight years later, compared to people who waited to get an organ from a deceased donor.
According to leading author, Dr. Dorry Segev of John Hopkins University in Baltimore, the terms have changed drastically. “We used to say if you had a compatible donor, you could do a transplant. Now you can say, if you have an incompatible donor, we still can make that transplant happen.”
More than 1,000 people received an HLA-incompatible kidney from a live donor; their eight-year survival rates were roughly 77 percent. For the 5,125 matched patients who stayed on a waiting list or received a kidney from a deceased donor, the rates were 63 percent, while for the 5,125 people who never received a kidney, 44 percent.
Segev, who is also the director of John Hopkins’ Epidemiology Research Group in Organ Transplantation, said the study showed just “how much longer the patient will live compared to their next available option.”
Even though getting a kidney from a compatible donor is the ideal solution, a lot of patients on a waiting list will never find one.
Conducted at 22 centers across the country, the study could improve the survival chances of the 32,000 people in the United States who have anti-HLA antibodies and are in need of a kidney transplant.
Dr. Sanjay Kulkarni, head of kidney and pancreas transplantation at Yale-New Haven Hospital and the Yale School of Medicine, who did not participate in the study, said that “It’s all about timing.” Being longer on dialysis decreases a patient’s chances of survival.
The paper suggests that even though the rate of rejection is higher in these cases, it’s better if patients get a transplant from an incompatible living donor in a couple of months, instead of waiting five years for a compatible donor.
The study published in the New England Journal of Medicine was accompanied by a commentary by Drs. Lionel Rostaing and Paolo Malvezzi of the Centre Hospitalier Universitaire Grenoble Alpes in La Tronche, France, who said that “The implications of these results are revolutionary.”
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