(Washington, DC, April 1, 2011) – A study of paired kidney exchanges that used pre and post-transplant therapies to match difficult-to-match recipients with donors and reduce the chance of rejection found that this method is a successful one in addressing the existing minority disparities in kidney transplant.
Just published in the April 2011 issue of the Journal of the American College of Surgeons, the study by Keith Melancon, MD, FACS, and other physicians within the Georgetown Transplant Institute found that minority patients defined as African American, Hispanic or of Asian descent, benefitted from the paired exchanges that used a pool of donors and recipients plus antibody rejection therapy.
In a paired kidney exchange, a potential recipient has a donor, but that donor isn’t a match either because of mismatched blood types or high levels of antibodies that would cause the recipient to reject the organ. So all potential donors and recipients are placed in a pool where donors are matched with people who are a recipient match or a closer match than the original donor.
“We know that minority patients make up 60% of the people listed for kidney transplantation in the United States,” said Dr. Melancon, surgical director of Kidney and Pancreas Transplant at the Georgetown Transplant Institute. “However, they receive only 55 percent of the deceased donor kidneys and 25 percent of living donor kidney transplants. This means they have less access, suffer more while they’re waiting and often are dependent on dialysis for a longer period of time, making them more prone to the antibody problems that make them tougher to ever transplant.”
Between January 2009 and December of 2010, transplant teams at Georgetown and Washington Hospital Center completed 60 living donor kidney transplants by paired exchange pools and used a combination of plasmapheresis and drug therapy to cleanse the blood of organ rejecting antibodies. Twenty four of the patients needed pre-and post transplant therapy and 36 were matched via a paired kidney exchange. Successful transplants were performed in 38 ethnic minorities, 33 of whom were African American. Twenty-two were Caucasian. Six months after transplant, 100 percent of the patients and their organs had survived. An acute rejection rate of 20 percent is comparable to traditional living donor transplantation. The last three large-scale kidney exchanges involving 13, 14 and 16 donor/recipient pairs set world records for the number of patients involved in a kidney exchange of their type.
“This study brings to light the fact that at the Georgetown Transplant Institute we have committed ourselves to performing more living donor kidney transplants in minority patients,” said Dr. Melancon. “We realize that the best outcomes from kidney transplantation are insured with living kidney donors. We have therefore endeavored to address the barriers to live donor kidney transplantation and have overcome those barriers with innovative solutions, like plasmaphoresis and paired kidney exchanges.”
Right now the United Network for Organ Sharing lists more than 87,000 people in the United States registered to receive a new kidney. Each year only 16,000 people are actually transplanted. Washington, DC has the highest rate of end-stage renal disease per capita of any state in the country, according to the National Kidney Foundation.
Media Contact: Marianne Worley
Patient Contact: 202-342-2400