Kidney transplants between patients with different blood groups are now possible at ISMETT
ABO incompatible kidney transplant program officially launched at UPMC ISMETT. This is the first kidney transplant ever performed in Sicily between incompatible patients, and others have already been scheduled in the next coming weeks. ABO incompatible transplants are already extensively performed in the United States and Japan, but in Italy only a few centers are offering them.
“Until a few years ago, blood group incompatibility was considered an absolute barrier and contraindication to a transplant,” explains Dr. Barbara Buscemi, director of the living donor kidney transplant program. “A different blood type to that of the donor resulted in an immediate attack of the graft by the recipient’s antibodies causing an organ rejection. Now, thanks to a desensitization protocol and the use of a drug, a monoclonal antibody, it is possible to overcome this obstacle and with a successful outcome.”
Prior to surgery the transplant recipient underwent a specific therapy, called plasmapheresis. This technique consists in removing pre-formed anti-A or anti-B antibodies connecting the patient to a machine through which the patient’s blood is cleaned of these antibodies, which otherwise would attack the organ causing rejection, by replacing it with protective immunoglobulins. At the same time, the immunosuppressive therapy and the monoclonal antibody infusion are started, reducing and blocking the production of antibodies. The procedure was performed in collaboration with doctors of the Transfusion Center of ARNAS Civico Hospital in Palermo, who conducted the apheresis sessions and monitored the antibody titer in the pre- and post-transplant stages.
“This is an important step forward for organ transplants in Sicily,” said Dr. Angelo Luca, Director of UPMC ISMETT, “and a tangible example of how innovation and research are extending the possibilities for patients waiting for a transplant. ISMETT is a highly reliable center of excellence for our community. The collaboration with the Transfusion Center of ARNAS Civico demonstrate how combining skills can lead to extraordinary results. We work tirelessly to push the boundaries of medical innovation, always reminding ourselves that behind every transplant there are people and families with their unique stories. It is to them that we passionately devote our work.”
A 58-year-old Sicilian man was the recipient of the kidney transplant, after three weeks of pre-treatment. The organ was procured with a minimally invasive laparoscopy technique, thus facilitating a rapid recovery for the donor, his 52-year-old wife. Husband and wife are both in good conditions: the woman was discharged after a few days and the man is being monitored and followed up at ISMETT’s Outpatient Clinic.