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ABO Incompatible and Paired Exchange Transplantation in Bhubaneswar

ABO Incompatible and Paired Exchange Transplantation

ABO Incompatible and Paired Exchange Transplantation in Bhubaneswar

ABO-incompatible and Paired Exchange Transplantation are two innovative strategies to address the shortage of organ donors. Because ABO incompatibility results in the formation of antibodies against the transplanted kidney, it is regarded as an absolute contraindication. This is because antibody-mediated rejection could cause early graft loss. Researching ways to use organs from ABO-I kidney donors is crucial, particularly as immunosuppressive medications become more potent. This may contribute to closing the gap between the number of recipients of Kidney Transplants and the available donor pool. ABO-incompatible Transplantation allows organs from donors with various blood types to be given to patients. To reduce the recipient's antibodies that would typically reject the organ, pre-transplant therapies such as Immunosuppressive Medications and Plasmapheresis are performed.

Incompatible donor-recipient couples are matched through Paired Exchange Transplantation, commonly referred to as Kidney Swapping. Transplant success rates are increased by matching suitable organs between donors and recipients. Organ donation has changed thanks to matched exchanges and ABO-incompatible transplants, which give patients on waiting lists access to life-saving options. These developments highlight the state of medicine and the continuous efforts to address transplant-related issues.

FAQ's

The classifications are based on microscopic particles (molecules) found on the surface of red blood cells. The immune system of individuals with one blood type may respond negatively when they receive blood from someone with a different blood type. This is known as ABO incompatibility. Fortunately, due to modern testing methods, this issue is extremely uncommon.

When a patient's GFR (glomerular filtration rate) is less than 15 mL/min, end-stage renal disease is identified. Individuals who have any of the following conditions are the best candidates for the procedure:

  • Graft failure
  • Glomerular syndrome
  • Diabetes
  • Interstitial and tubular diseases
  • Renovascular and other vascular diseases
  • Metabolic or congenital conditions

Matching with the Type O blood type, which is the universal donor blood type for a Kidney Transplant, can be challenging. People with blood type O may only get kidneys from other Type O donors, making it more challenging to find a matching donor.

Getting a Kidney Transplant from an incompatible donor has several risks. The patient's immune system may attack the new kidney, causing rejection or damage. Risks include: 

  • Rejection of the transplanted kidney: Sometimes, the recipient’s body might not accept a newly donated kidney. Doctors need to be aware of these potential causes so they can take the necessary steps to prevent renal rejection and preserve kidney function. 

  • Infections: Kidney Transplants can cause infections if the recipient's immune system attacks them. Infections can be dangerous, especially for people with weakened immune systems. Transplant patients need close monitoring to prevent and treat infections.

  • Surgical consequences: Incompatible Kidney Transplants can cause surgical complications. For example, rejection of the transplanted kidney may cause significant pain and discomfort. Infections may also require further procedures to fix the issue, causing tremendous inconvenience to the patient.

  • Allergy Reactions: Drugs and therapies that reduce antibody levels may have other adverse effects in addition to allergic reactions.

Incompatible donor-recipient pairings are partnered with other donor-recipient pairs in Paired Exchange Kidney Transplantation. Kidneys are surgically removed from donors and subsequently transplanted into compatible recipients from a different pair. In a matched pair, recipients receive the kidney from the donor. Usually, the procedures are carried out simultaneously or shortly after one another. To guarantee a successful transplant and the best possible outcomes for every participant, the procedure entails extensive examination, matching, and coordination amongst transplant centres.

There are several advantages to Kidney Transplantation with paired exchange:

  • Increased Donor Pool: By allowing incompatible partners to take part, the number of donation opportunities is increased.

  • Enhanced Compatibility: Lowers the likelihood of rejection through improved matching

  • Reduced Wait Times: Matching organs more quickly leads to a shorter wait time for transplants.

  • Expanded Availability: Offers prospects to patients who encounter problems with donor suitability.

  • Enhanced Outcomes: Raising life satisfaction and success rates of treatment.

  • Benefits Patients: Provides kidneys that last longer, possibly requiring fewer prescription drugs.

  • Mutual Support: Encourages reciprocity and a sense of belonging between givers and receivers

A donor who has an incompatible recipient is willing to donate a kidney to another recipient who also has an incompatible donor in a kidney exchange. Two categories of exchange procedures exist.

In paired or repeated exchanges, two sets of donors and recipients are included. The original incompatible pairs of donor and recipient are matched with another set. In the given scenario, the donor on the left donates to the recipient on the right, and the donor on the right donates to the recipient on the left.

Kidney chains get more compatible donors by involving more people. They start when a donor offers a kidney to an unknown recipient. The incompatible recipient will get a kidney from another donor.

The specific aspects of KPE require donors and recipients to carefully consider and receive help throughout the entire process, even if the risks for both the donation procedure and the recipient are the same as those for direct donation. KPE poses the following risks:

  • Stress while awaiting a potential match.

  • There is the possibility of more blood draws throughout the matching procedure.

  • Distress or depression if the KPE procedure is unsuccessful.

  • Differences in expenses when compared to direct donations.

  • In some instances, the kidney cannot be transplanted due to damage during the transit process.

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