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Tuesday, 30 April, 2002, 22:59 GMT 23:59 UK
Advance could boost kidney transplants
Kidney op
Organs for kidney transplant are scarce
A blood-filtering method which should reduce the threat of organ rejection could help more patients have life-saving transplants.

It could mean that, in the case of kidney transplants, organs from donors whose tissue and blood type does not match the recipient, could be used.

Other patients whose immune systems would attack even organs from closely-matched relatives could also benefit.

However, it is not clear whether the system could help delay the long-term rejection of an organ which reduces the working life of a transplanted organ.

The results of a trial at Johns Hopkins University in Baltimore US, were presented to a transplantation conference in Washington on Tuesday.

The technique involves taking the blood from the organ recipient, and manipulating it to remove its fluid, or plasma.

This contains antibodies - the body's immune "memory", primed to recognise and attack foreign invaders.

Success measured

Fresh fluid is put back into the body, and this process repeated several times before the transplant operation takes place.

Many of these patients have been repeatedly told there is no hope of ever receiving a kidney transplant

Dr Robert Montgomery, Johns Hopkins Medical Center
A total of 29 patients underwent this process, and were given organs previously thought to be incompatible.

Although they still need to take immune-suppressing drugs full-time, to guard against other forms of rejection, 27 of these are doing well.

Dr Robert Montgomery, the study's lead author, told the conference: "Many of these patients have been repeatedly told there is no hope of ever receiving a kidney transplant.

"With this innovation, I can tell any patient who has a live donor and is medically eligible that they can be transplanted with a high degree of success.

"It has the potential of increasing the number of living donor transplant operations by one-third to one-half."

Failing supply

Currently, the demand for transplant kidneys far outstrips the number which become available, and doctors match up donor organs with suitable patients so that very few are wasted.

Fewer organs have become available in recent years due to improvements in road safety, and, at present, living donor operations are the only way to make up the shortfall.

However, if there are no suitable matches among close relatives, or if the patient's immune system has been sensitised to proteins in donor tissues by previous transplants, blood transfusions or multiple pregnancies, then no other options are available.

Dr Simi Ali, a lecturer in immunobiology at the University of Newcastle said that preventing this "antibody-mediated" rejection could be useful in these cases, in which the rejection is immediate and devastating.

However, she said, it might have no bearing on longer-term chronic rejection, which reduces the life of the transplanted organ.

At present, a kidney, on average, lasts for approximately eight to 10 years.

She said: "Donor matching is so good these days that antibody rejection would not be an issue for most patients.

"However, the length of time a transplanted kidney keeps working in the body has not improved much in recent years."

See also:

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