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publicado em 17/03/2013 às 14h30:00
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Hospital de Sao Paulo performs first kidney transplant incompatible country

Procedure is known as ABO incompatible, in which the donor and receiver do not have the same blood type

 
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Procedure unprecedented in the country and can be a hope for patients who are in the queue waiting for a kidney transplant was performed successfully at Samaritan Hospital in St. Paul. This is known as the ABO incompatible transplantation, wherein the donor and receiver do not have the same blood type.

The innovative technique is already used successfully for over ten years in Japan - a pioneer in the procedure - in the United States and Europe. In Brazil, it was the first time that experts used the method.

ABO Incompatible Renal transplantation was performed in a 28 years waiting for an organ since 2008. The patient was undergoing hemodialysis three times a week, is blood type O and received her mother's kidney, 63, who has type A.

According to the doctor who led the surgery team, Maria Cristina Ribeiro de Castro, in general, in renal transplantation, the first test is performed to check the compatibility of blood type, which uses the same principle of blood donation: type O can donate to anyone, but only receive O, AB receives from any person, type A only receive A or O, and Type B only gets B or O.

Statistics show that 30% to 40% of donors are already rejected this first test, by presenting a group of incompatible blood.

In Japan, the problem was even greater because brain death was not validated for religious reasons, and was not, therefore, deceased donation. Therefore, Japanese experts began testing methods that would enable renal transplantation between donors and recipients of different blood types and found that it is possible to obtain results similar to those of ABO-compatible transplants.

The donor was discharged in three days and transplanted at 20 days. There were no complications and kidney function is excellent

<b> Preparation </ b>

The ABO incompatible transplant preparation is similar to what is already used in some centers for patients sensitized Brazilians: those with high levels of antibodies to the HLA system. Everyone has their cells in a series of antigens that identifies us. Patients who already have another transplant, or have undergone transfusions or pregnancies, had contact with antigens and others may develop antibodies to the HLA system of potential donors. This is also a condition that prevents the transplant to be done if these antibodies are not reduced, explains.

Plasmapheresis <b> </ b>

There are basically two types of treatment for these two conditions: plasmapheresis, which consists of a plasma filtering, removing the antibodies, and the use of biological drugs that prevent the production thereof.

In patients Brazilian experts, in partnership with the Blood Bank Samaritan Hospital of São Paulo using the method of plasmapheresis, which is performed only on the receiver. There were six sessions before transplantation and five in the first weeks. It is a measure to leave a safe level of antibodies to the immunosuppressive and can act to occur naturally accommodation to donor antigens.

The transplant was performed three months ago. The donor was discharged in three days and transplanted at 20 days. There were no complications and kidney function is excellent. The procedure integrates project connected to the Support Program for Institutional Development of the Unified Health System (SUS-PROADI), the Ministry of Health

Source: Isaude.net
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