Advances Expand Kidney Transplants

Approximately 3 out of every 10 kidney transplant candidates test positive for P.R.A, a blood test that looks for panel-reactive antibody - proteins ready to attack foreign material. Patients with P.R.A present in their blood could not receive a transplant because of the high risk of their body simply rejecting the new kidney.

This happened to Soraya Kohanzadeh who suffered from kidney failure after a congenital heart defect was corrected during surgery. Kohanzadeh was told that she was not a suitable candidate for a kidney transplant because of her high antibody levels but she did not take no for an answer. After researching and discovering transplant specialists in Los Angeles, Kohanzadeh found that studies were taking place exploring ways to lower levels of antibodies in patients in need of a transplant. The strategy included giving patients high levels of IVIG, intravenous immunoglobulin, before surgery to desensitize the body. Kohanzadeh was able to get a kidney transplant along with 200 other patients that have been treated by the same Medical Center after desensitization with IVIG.

There was always little hope for patients on long term dialysis to come off anytime soon, but with IVIG, patients can receive the necessary kidney transplant and quit such an obnoxious and time-consuming procedure. Known causes of high P.R.A blood levels include blood transfusions, pregnancy, and previous transplants.

Because doctors are particular about which patients can and cannot receive transplants, increasing the patients' success rate will provide the doctors with the incentive to do surgery on more people. It will prevent them from performing a series of failed surgeries while providing more patients with the opportunity to get a transplant when they would not have had that opportunity previously.

The next step in research includes attempting to increase success rates even more by preventing the antibodies from returning also preventing future rejection.

http://www.nytimes.com/2009/04/28/health/28kidn.html?_r=1&ref=health

VTPP 435-502

Brittany Sanchez