Kidney transplants may not need ‘perfect match’: study

Kidney transplants may not need ‘perfect match’: study

According to a new, long-term study, transplanting a mismatched kidney from a living donor may lower the risk of death more than forgoing the transplant entirely.

The study could make way for more operations and transplants. Researchers confirmed recipients who have incompatible immune systems with the donor’s kidney were more likely to be alive eight years later than avoiding the operation, or waiting for the organ from a deceased donor.

“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,” senior author Dr. Dorry Segev of John Hopkins University in Baltimore said in an interview with Reuters Health.

“That’s very exciting to those on the waiting list.”

Looking closer into that eight-year time frame, scientists saw survival rates of 77% for patients (1,025 in total) taking incompatible kidneys; 63% (out of 5,125) for those who remained on a waiting list for a kidney or received a kidney from a deceased donor; 44% (out of 5,125 people again) who didn’t receive a kidney, compatible or not.

“The paper is showing how much longer the patient will live compared to their next available option,” continued Segev.

“Your next best option is waiting on the list for a compatible donor, and a lot of those patients will never find one.”

The study spanned across 22 health centres. It could help the more than 32,000 people in the United States who have anti-HLA antibodies – which cause the compatibility issue between kidney and recipient – and need a transplant.

“The implications of these results are revolutionary, especially when the numerous contradictory opinions raised by the transplant community are considered,” said Drs. Lionel Rostaing and Paolo Malvezzi of the Centre Hospitalier Universitaire Grenoble Alpes in La Tronche, France.

The only hurdle is patients must be desensitized, and those immunosuppressive regimens are expensive, and can potentially cause infections or cancer. Living donors face a small but significant increase in their risk of end stage renal disease, too.

Still, most experts like Rostaing and Malvezzi agree: using incompatible kidneys from living donors “may save lives and may be cost-effective over time.”

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