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New Mayo Clinic approach to kidney transplants means more patients can be successfully transplanted

lant. We basically turned the driver into the living donor."

Mayo Clinic's New Approach

The Mayo Clinic transplant team's key innovations are:

  • A new approach to blood tests that historically have been used to determine a good match between a patient and a donor. Instead of looking for a simple "yes-antibodies-are-present/no-antibodies-are-not-present" answer to cross-matching tests, the Mayo group considered the amount of a given antibody present in the blood. Says Dr. Gloor, "Maybe the amount of antibody against the donor may really in fact be just a tiny, tiny amount. But it's enough to turn the test to positive. In the past, we would have looked at that positive and it would work against the patient's eligibility. But now we can look at the amount of antibody, not just the presence of it. And we can see the cases when it's not much -- not real positive -- not enough to endanger the transplant."

  • Filtering out antibodies from the patient's blood to create a less hostile environment for the donor kidney so it can adapt. Using the idea of a wide array of antibodies that have a shallow effect -- amounts that are tiny but still sufficient to turn the cross-match test positive -- the Mayo Clinic team found that through a series of dilutions of a patient's blood, they could get a progressively weaker solution of antibodies. They could get it so weak, in fact, that the cross-match test couldn't pick it up. When they reached this point, the cross-match test would then be negative -- and a kidney transplant could safely proceed.

    The Technology

    To dilute a patient's antibody profile, doctors used a well-known and easily obtainable technology in a new way. They sent patients through a series of blood-filtering treatments called plasmapheresis. In it, blood is taken from the patient's body and spun in a centrifuge that sends the red blood cells to the periphery. The fluid part of the blood containing most of the
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    • Contact: Sara Lee
    newsburea@mayo.edu
    507-284-5005
    Mayo Clinic
    27-Aug-2003


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