Cross kidney transplantation is a transplant method in which two foreign pairs exchange kidneys. Cross kidney transplantation offers hope for patients who do not have a related person to donate a kidney to them, and who cannot find a deceased donor. What is cross transplant? What are the advantages of this method of transplantation?

Kidney cross-transplantfrom unrelated living donors is a method of transplantation in which two foreign pairs exchange kidneys. The idea to transplant organs "crosswise" was born in the late 1980s in the USA. However, in the United States, the first cross transplant was not performed until 2000 at Johns Hopkins Hospital. Today, cross transplantation is popular not only in America (one in ten living donors is a cross transplant), but also in Switzerland, the Netherlands, Great Britain, Australia and Canada. In Poland, the first such procedure was performed on February 10, 2015.

Cross kidney transplant - what is it?

The patient usually receives a kidney from a close family member. However, it happens that there is no genetic compatibility between the donor and the recipient, despite the relationship - the blood group differs or the blood group is compatible, but the so-called the cross-match is positive, i.e. the recipient produces antibodies against the donor's tissues, which could lead to rejection of the transplant.

Then such a pair goes to the database and waits for a pair with a similar problem to be found. If, after the tests, it turns out that there is 100% antigen compatibility between two foreign pairs, a cross-transplant can be performed, i.e. the patient from the first pair receives the donor's kidney from the second pair, which, despite being a stranger to the patient, turned out to be his "genetic twin". In return, the kidney of the donor from the first pair goes to the stranger of the recipient from the second pair.

It's good to know that a kidney transplant can involve not only two, but also three, four, or even six couples who are different from each other. Then we are talking aboutchain transplant.

Cross kidney transplantation - advantages of this method of transplantation

Thanks to the possibility of cross-transplant, the queue of people waiting for a kidney is shortened,which is very long in Poland. In 2013, 2,565 people were placed on the national waiting list for this organ transplant. However, there were only 1,134 surgeries. In 2013, 59 people waiting for a kidney died without having a transplant.

Also, the kidney is from a living donor, not a deceased donor, which is of great importance. In the case of a living donor, the kidney remains outside the body (and thus - it is not supplied with blood) for only 2 hours, and in the case of a deceased donor - at least 20 hours. Therefore, a living kidney is of better quality and works much longer after transplantation (15 years on average) than that of a dead donor (10 years). As a consequence, people who receive a kidney from a living donor live longer than those who receive an organ from a deceased donor.

Costs are also important. People who wait for kidney transplants are sentenced to dialysis even for years. And the cost of one dialysis treatment in Poland is about PLN 400, which means that PLN 62,000 is spent annually for one patient. zloty. However, the cost of a kidney transplant is approx. PLN 5,000. PLN.

Important

Cross kidney transplant - court approval required

By law, the collection of cells, tissues or an organ from a living donor to be donated to a non-direct relative, sibling, adopted person or spouse requires the consent of the district court having jurisdiction over the place of residence or stay donor. The court initiates proceedings at the request of the donor candidate, after hearing the donor and after hearing the opinion of the Ethics Committee of the National Transplantation Council. The decision is usually made quite quickly, because in non-litigious proceedings.

Poland's first cross kidney transplant

In Poland, the first cross kidney transplant took place on February 10, 2015 at the Department of General and Transplant Surgery of the Infant Jesus Clinical Hospital in Warsaw. The operation was led by prof. Artur Kwiatkowski, who is the co-author of the living kidney donor program and the first Polish coordinator of the "Living Kidney Donor" program and the ministerial program for the development of transplant medicine for 2011-2020, as well as Prof. Andrzej Chmura, who is the head of the clinic where the surgery took place , and Dr. Rafał Kieszek. Two couples took part in the operation.

Couples who would be interested in cross transplant can contact the coordinator of the Warsaw clinic, Aleksandra Tomaszek.

Category:

Urology and Nephrology