kidney transplant and plasma exchange?

I am wanting to donate my kidney to my dad, but he has type O blood, where I am A- . I know that it’s more than just blood that needs to be compatible, but this was my biggest fear. I researched a little bit and found something called plasmapheresis (where they purge his body of antibodies in a dialysis type treatment). Has anyone tried this or knows how well it would work with a transplant? And would this work with all blood types including O?

  1. Gary B, 08 May, 2010

    "Plasmapheresis is used to remove antibodies from the bloodstream, thereby preventing them from attacking their targets. It does not directly affect the immune system’s ability to make more antibodies"

    Your best best is to see of the transplant center has an "exchange" plan.

    It is not really possible for you to donate a kidney DIRECTLY to your father, based on blood type alone. Plasmapheresis does not work in the case of a transplant, because the removal of antibodies is only temporary. Your Dad’s body WOULD make new antibodies, and he would need another plasmapheresis treatment (very expensive!!) again in a few days — and again and again for the rest of his life. Eventually, the insurance would stop paying for it, and he WOULD die.

    But if the transplant center works on an "exchange" basis, it is possible that your kidney might work in someone else, and if they took you kidney it would move your Dad up "higher" on the list.

    This does not guarantee that your Dad WILL get a kidney — that would depend on who might be a suitable match. But WHEN a suitable match comes along, your "exchange" means that your Dad will get it sooner.

    I am:
    1) Waiting for a kidney transplant
    2) A Dad with a daughter.

    I CAN tell you that as a Dad I would much rather that my daughter save someone else’s life and give me a better chance of getting a good match, than to know that, even with plasmapheresis, her kidney in me would fail.

    I can also tell you that as a Dad, your thoughts of being willing to do this are probably more important to him than actually doing it. Just WANTING to do this says "I love you" louder than you’ve ever said it before. I know, because my daughter has said the same thing in the same way.

  2. RJCF, 17 November, 2010

    I have just donated a kidney to my husband despite us being ABO incompatible – I am B, he is A. He had plasmapheresis sessions prior to the transplant to remove his antibodies, and they were very successful. He has not needed any plasmapheresis since, although it is still early on. But so far, there have not been any signs of rejection.
    So yes, it does enable ABO incompatible direct transplants in some cases. However, whether it is possible still depends on each pair of individuals. We were told that it is harder for a type O recipient to receive an incompatible kidney.
    It is definitely worth exploring in my opinion. The hospital will carry out many tests to see whether it is a possibility, including mixing your blood together. They won’t pursue it if there is no chance of it working. Instead, you could then consider a paired or pooled transplant.
    I wish you all the best.

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