These patients have historically been ineligible for transplants because they have high levels of antibodies in their blood that suggest they would reject the organ. Yet the Mayo Clinic team has transplanted kidneys into 29 patients in this most-difficult-to-treat group of patients, with an 80 percent success rate. One to three years following the operations, 23 of the 29 patients have good, healthy functioning kidneys.
Currently 7,00010,000 people in the U.S. are in this most-difficult-to-transplant group. They often undergo regular dialysis and wait for a compatible donor organ that their antibodies won't attack.
"Sadly, they'll languish on the waiting list," says James Gloor, M.D., a transplant nephrologist on the Mayo Clinic team. "As soon as a donor kidney becomes available, this subset of patients usually turns out to have antibodies against it, so they don't get a transplant and end up going back on the waiting list, waiting for a donated organ that they don't have antibodies against. But because they have such high antibody levels, the desired 'negative cross-match' as it's called, hardly ever happens. This can go on for 10 to 15 years. They often die on the waiting list, waiting for a negative cross-match," says Dr. Gloor.
Adds Mark Stegall, M.D., head of the transplant team: "The irony of this protocol is that some patients have been going to dialysis for 10 years -- and their donor has been driving them there all the 10 years. The presence of the antibodies in the recipient has prevented a transplant from the otherwise-acceptable living donor. Now, with just a little bit of manipulation of the patient's immune system, we've been able to perform the transp
Contact: Sara Lee