New Procedure Makes A Successful Transplant Possible

University Of Maryland Doctors Devise Method To Prevent Severe Rejection

Six critically ill people on kidney dialysis have been able to receive a kidney transplant and a new chance at life thanks to a procedure at the University of Maryland Medical Center that cleansed their blood of harmful rejection antibodies.

The success of this innovative procedure, called High PRA Rescue, will be presented at the American Society of Transplant Surgeons annual convention in Chicago on May 19 by Eugene Schweitzer, M.D. It is the first time the procedure has been tried in combination with three new anti-rejection drugs.

"These six patients had loved ones who were willing to give them a kidney, but because of their high PRA, their body would have rejected the new kidney immediately," says Dr. Schweitzer, a transplant surgeon at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine.

High PRA, which stands for "high panel reactive antibody," affects at least 20 percent of people on the U.S. kidney transplant waiting list. It can significantly increase their waiting time to receive a suitable donated kidney. For example, a person with a PRA of 50 means that half of the possible kidneys that became available would be unacceptable. In 1993, patients with a low PRA who received transplants had waited an average of 535 days, while those with the highest PRA waited 1,974 days for a suitable organ.

A person can develop high PRA after having a pregnancy, a previous blood transfusion, or an earlier kidney transplant. High PRA presents a different, much more potent risk of rejection than cell-mediated rejection, which all transplant patients face.

"High PRA can cause immediate rejection of a transplanted kidney, in spite of the powerful anti-rejection medications we have available," says Stephen T. Bartlett, M.D., head of the division of transplant surgery at the University o

Contact: Ellen Beth Levitt
University of Maryland Medical Center

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