Jump to content
The World News Media

New Procedure Allows Kidney Transplants From Any Donor


Guest Nicole

Recommended Posts

  • Guest
Guest Nicole

10KIDNEY-1457552877210-master675.jpg

Clint Smith, at home in New Orleans, had a procedure that altered his immune system to allow his body to accept a kidney from an incompatible donor. It “changed my life,” he said. Credit William Widmer for The New York Times

 

In the anguishing wait for a new kidney, tens of thousands of patients on waiting lists may never find a match because their immune systems will reject almost any transplanted organ. Now, in a large national study thatexperts are calling revolutionary, researchers have found a way to get them the desperately needed procedure.

In the new study, published Wednesday in The New England Journal of Medicine, doctors successfully altered patients’ immune systems to allow them to accept kidneys from incompatible donors. Significantly more of those patients were still alive after eight years than patients who had remained on waiting lists or received a kidney transplanted from a deceased donor.

The method, known as desensitization, “has the potential to save many lives,” said Dr. Jeffery Berns, a kidney specialist at the University of Pennsylvania’s Perelman School of Medicine and the president of the National Kidney Foundation.

It could slash the wait times for thousands of people and for some, like Clint Smith, a 56-year-old lawyer in New Orleans, mean the difference between receiving a transplant and spending the rest of their lives ondialysis.

The procedure, Mr. Smith said, “changed my life.”

Researchers estimate about half of the 100,000 people in the United States on waiting lists for a kidney transplant have antibodies that will attack a transplanted organ, and about 20 percent are so sensitive that finding a compatible organ is all but impossible. In addition, said Dr. Dorry Segev, the lead author of the new study and a transplant surgeon at the Johns Hopkins University School of Medicine, an unknown number of people with kidney failure simply give up on the waiting lists after learning that their bodies would reject just about any organ. Instead, they resign themselves to dialysis, a difficult and draining procedure that can pretty much take over a person’s life.

Desensitization involves first filtering the antibodies out of a patient’s blood. The patient is then given an infusion of other antibodies to provide some protection while the immune system regenerates its own antibodies. For some reason — exactly why is not known — the person’s regenerated antibodies are less likely to attack the new organ, Dr. Segev said. But if the person’s regenerated natural antibodies are still a concern, the patient is treated with drugs that destroy any white blood cells that might make antibodies that would attack the new kidney.

The process is expensive, costing $30,000, and uses drugs not approved for this purpose. The transplant costs about $100,000. But kidney specialists argue that desensitization is cheaper in the long run than dialysis, which costs $70,000 a year for life.

Although by far the biggest use of desensitization would be for kidney transplants, the process might be suitable for living-donor transplants of livers and lungs, researchers said. The liver is less sensitive to antibodies so there is less need for desensitization, “but it’s certainly possible if there are known incompatibilities,” Dr. Segev said. With lungs, he said, desensitization “is theoretically possible,” although he said he was not aware of anyone doing it yet.

In the new study, 1,025 patients at 22 medical centers who had an incompatible donor were compared to an equal number of patients who remained on waiting lists for an organ or who had an organ from a deceased but compatible donor. After eight years, 76.5 percent of those who received an incompatible kidney were still alive, compared with 62.9 percent who remained on the waiting list or received a deceased donor kidney and 43.9 percent who remained on the waiting list but never got a transplant.

The desensitization procedure takes time — for some patients as long as two weeks — and is performed before the transplant operation, so patients must have a living donor. It is not known how many have someone willing to donate a kidney, but doctors say they often see situations in which a relative or even a friend is willing to donate but is incompatible.

“Often patients are told that their living donor is incompatible, so they are stuck on waiting lists,” for a deceased donor, Dr. Segev said.

In recent years, an option called a kidney exchange has helped some in this situation. Patients who have incompatible living donors can swap donors with someone whose donor may be compatible with them. Often, there are chains of patient-donor pairs leading to a compatible organ swap.

That process can be successful, said Dr. Krista L. Lentine, the medical director of the living donation program at the Saint Louis Center for Transplantation, but patients often still cannot find a compatible organ because they have antibodies that would reject almost every kidney. In those cases, “desensitization may be the only realistic option for receiving a transplant,” said Dr. Lentine, who was not involved with the study.

Dr. Jeffrey Campsen, a transplant surgeon at the University of Utah Health Sciences Center who also was not a study investigator, said his group focused on exchanges and had been fairly successful. But he also comes across patients whose donors do not want to participate. “There is a hurdle if the donor and patient have an emotional bond,” he said.

The new data showing the success of desensitization “lets people get behind it,” Dr. Campsen said, adding, “I do think it is something we would consider.”

Mr. Smith, the New Orleans patient who went through desensitization, had progressive kidney disease that slowly scarred his kidneys until, in 2004, they stopped functioning. His sister-in-law, Allison Sutton, donated a kidney to him, and he had a transplant, but after six and a half years, it failed. He went on dialysis, spending four days a week hooked up to dialysis machines for hours. It was keeping him alive, he told his friends, but it was not a life.

Then a nurse suggested that he ask Johns Hopkins about its desensitization study. “I was like, whatever I could do,” he said. He discovered that he qualified for the study. But he needed a donor.

One day, his wife, Sheryl Smith, was talking on the phone to a college friend, Angela Watkins, who lives in Augusta, Ga., and mentioned that Mr. Smith was praying for a donor. Mrs. Watkins’s husband, David Watkins, a judge in state court, had been friends with Mr. Smith in college and the two wives, also college friends, had kept in touch over the years.

Mrs. Watkins told her husband about the conversation, and they asked themselves if they should offer to donate.

“We talked and researched and prayed,” Judge Watkins said. Finally, he said, they came to a conclusion. “We have a moral obligation to at least see if we would qualify.” And he thought that he should be the one to go first. If he did not qualify, his wife could be tested.

Mr. Smith warned his old friend that donating was an enormous undertaking. “He said, ‘You can’t grasp what you are doing.’ I heard him but it didn’t register,” Judge Watkins said. “I told him, ‘I have something you need, so what’s the big deal?’ ”

Of course, it was a big deal. Although Judge Watkins had prepared by getting himself in top physical shape, it still took about six months to recover from the operation.

That was four years ago, and Mr. Smith’s new kidney is still functioning and he is back to his active life, forever grateful to his friend.

“Every night,” he says, “during my nightly prayers with my wife, I thank God for bringing David and Allison to me and for giving me the gift of life.

“But for David giving me this gift, I would still be in that dialysis chair.”

Correction: March 9, 2016 
Because of an editing error, an earlier version of this article misstated the role of Dr. Krista L. Lentine, the medical director of the living donation program at the Saint Louis Center for Transplantation, in the study of kidney transplants. She was not involved.

Source:http://www.nytimes.com/2016/03/10/health/kidney-transplant-desensitization-immune-system.html?ref=health

Link to comment
Share on other sites


  • Views 603
  • Replies 0
  • Created
  • Last Reply

Popular Days

Posted Images

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...




  • Recently Browsing

    • No registered users viewing this page.
  • Popular Contributors

  • Topics

  • Posts

    • It appears to me that this is a key aspect of the 2030 initiative ideology. While the Rothschilds were indeed influential individuals who were able to sway governments, much like present-day billionaires, the true impetus for change stems from the omnipotent forces (Satan) shaping our world. In this case, there is a false God of this world. However, what drives action within a political framework? Power! What is unfolding before our eyes in today's world? The relentless struggle for power. The overwhelming tide of people rising. We cannot underestimate the direct and sinister influence of Satan in all of this. However, it is up to individuals to decide how they choose to worship God. Satanism, as a form of religion, cannot be regarded as a true religion. Consequently, just as ancient practices of child sacrifice had a place in God's world, such sacrifices would never be accepted by the True God of our universe. Despite the promising 2030 initiative for those involved, it is unfortunately disintegrating due to the actions of certain individuals in positions of authority. A recent incident serves as a glaring example, involving a conflict between peaceful Muslims and a Jewish representative that unfolded just this week. https://www.theguardian.com/world/2024/mar/11/us-delegation-saudi-arabia-kippah?ref=upstract.com Saudi Arabia was among the countries that agreed to the initiative signed by approximately 179 nations in or around 1994. However, this initiative is now being undermined by the devil himself, who is sowing discord among the delegates due to the ongoing Jewish-Hamas (Palestine) conflict. Fostering antisemitism. What kind of sacrifice does Satan accept with the death of babies and children in places like Gaza, Ukraine, and other conflicts around the world, whether in the past or present, that God wouldn't? Whatever personal experiences we may have had with well-known individuals, true Christians understand that current events were foretold long ago, and nothing can prevent them from unfolding. What we are witnessing is the result of Satan's wrath upon humanity, as was predicted. A true religion will not involve itself in the politics of this world, as it is aware of the many detrimental factors associated with such engagement. It understands the true intentions of Satan for this world and wisely chooses to stay unaffected by them.
    • This idea that Satan can put Jews in power implies that God doesn't want Jews in power. But that would also imply that God only wants "Christians" including Hitler, Biden, Pol Pot, Chiang Kai-Shek, etc. 
    • @Mic Drop, I don't buy it. I watched the movie. It has all the hallmarks of the anti-semitic tropes that began to rise precipitously on social media during the last few years - pre-current-Gaza-war. And it has similarities to the same anti-semitic tropes that began to rise in Europe in the 900's to 1100's. It was back in the 500s AD/CE that many Khazars failed to take or keep land they fought for around what's now Ukraine and southern Russia. Khazars with a view to regaining power were still being driven out into the 900's. And therefore they migrated to what's now called Eastern Europe. It's also true that many of their groups converted to Judaism after settling in Eastern Europe. It's possibly also true that they could be hired as mercenaries even after their own designs on empire had dwindled.  But I think the film takes advantage of the fact that so few historical records have ever been considered reliable by the West when it comes to these regions. So it's easy to fill the vacuum with some very old antisemitic claims, fables, rumors, etc..  The mention of Eisenhower in the movie was kind of a giveaway, too. It's like, Oh NO! The United States had a Jew in power once. How on earth could THAT have happened? Could it be . . . SATAN??" Trying to tie a connection back to Babylonian Child Sacrifice Black Magick, Secret Satanism, and Baal worship has long been a trope for those who need to think that no Jews like the Rothschilds and Eisenhowers (????) etc would not have been able to get into power in otherwise "Christian" nations without help from Satan.    Does child sacrifice actually work to gain power?? Does drinking blood? Does pedophilia??? (also mentioned in the movie) Yes, it's an evil world and many people have evil ideologies based on greed and lust and ego. But how exactly does child sacrifice or pedophilia or drinking blood produce a more powerful nation or cabal of some kind? To me that's a giveaway that the authors know that the appeal will be to people who don't really care about actual historical evidence. Also, the author(s) of the video proved that they have not done much homework, but are just trying to fill that supposed knowledge gap by grasping at old paranoid and prejudicial premises. (BTW, my mother and grandmother, in 1941 and 1942, sat next to Dwight Eisenhower's mother at an assembly of Jehovah's Witnesses. The Eisenhower family had been involved in a couple of "Christian" religions and a couple of them associated with IBSA and JWs for many years.)
  • Members

    • R. Gray

      R. Gray 0

      Member
      Joined:
      Last active:
  • Recent Status Updates

  • Forum Statistics

    • Total Topics
      65.4k
    • Total Posts
      158.9k
  • Member Statistics

    • Total Members
      17,670
    • Most Online
      1,592

    Newest Member
    Apolos2000
    Joined
×
×
  • Create New...

Important Information

Terms of Service Confirmation Terms of Use Privacy Policy Guidelines We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.