Chain kidney transplantation is a method of transplantation in which at least three foreign pairs exchange kidneys. The donors are not related to each other, but to help their relatives who are sick, they donate the kidney to others in need. What is chain transplant? What are the advantages of this method of transplantation?

Kidney chain transplantfrom unrelated living donors is a method of transplantation in which three or more foreign pairs are exchanged with the kidneys. The idea to transplant the kidneys in this way was in 1986 by Felix T. Rapaport of Stony Brook University. The first such program in the world was launched in South Korea in 1991. Currently, chain transplants are carried out in Switzerland, the Netherlands, the United Kingdom, the United States, Australia and Canada. The first in Poland chain kidney transplant took place on June 23, 2015.

Chain kidney transplant - what is it?

The patient usually receives a kidney from a close family member. However, it happens that there is a blood group or immunological incompatibility between the donor and recipient despite being related, i.e. the recipient produces antibodies against the donor's tissues, which could lead to rejection of the transplant.

The solution is kidney cross transplant. However, if it cannot be performed (because a compatible pair cannot be found), doctors may consider chain transplantation. Then, people who wanted to donate a kidney to a loved one, donate it to another patient. In return, a family member of the person who got the kidney donates his organ to another in need of the chain.

The first chain kidney transplant in Poland was attended by 6 people (3 pairs) - a son (Mr. Krystian) who wanted to donate a kidney to his mother (Mr. Danuta), but it was not possible due to immunological incompatibility, a sister (Ms Jolanta) who, due to the incompatibility of blood types, was unable to help her brother (Ms Jacek), and a husband (Ms Anselm) who, also for immunological reasons, could not donate an organ to his wife (Ms Elżbieta).

Mr. Krystian's kidney, which was to be given to his mother, went to Mr. Jacek. In return, Mr. Jacek's sister gave the kidney to Mrs. Elżbieta, whose husband - Mr. Anselm - gave the kidney to Mrs. Danuta.

These people were immunologically matched thanks to the work of a team of immunologists and a special computer program.

Kidney Chain Transplant - Advantages of this Transplant Method

Thanks to the possibility of chain transplantation, the queue of people waiting for a kidney, which is very long in Poland, is shortened. Besides, the organ comes from a living donor, not a deceased one, which is of great importance. A living kidney is of better quality and works longer. Moreover, the kidney chain transplant is worthwhile for financial reasons. Certainly, the costs of such a procedure are lower than the costs of many years of dialysis of sick patients.

This will be useful to you

The largest chain kidney transplant took place in the United States. Nine pairs took part in it, which means that as many as 18 operations were carried out at the same time. It is worth knowing that in some centers where transplants are carried out, already 50 percent. transplants from living donors are chain transplants.

Poland's first chain kidney transplant

In Poland, the first chain kidney transplant took place on June 23, 2015 at the Department of General and Transplant Surgery of the Infant Jesus Clinical Hospital in Warsaw. This complicated operation lasted a little over 12 hours and was performed by prof. Andrzej Chmura, prof. Artur Kwiatkowski and Dr. Rafał Kieszek (the same team of doctors performed the first cross kidney transplant in Poland in February 2015). At the same time, they performed as many as 6 operations. The transplant coordinator of the entire project is Aleksandra Tomaszek, MA.

Important

Kidney chain transplant - court approval required

In Poland, according to the law, only a related donor can be a living organ donor (to prevent organ trafficking). However, in exceptional cases, the court may authorize transplantation from unrelated living donors. The court commences proceedings upon the request of the candidate or candidates for donors, after hearing them and after hearing the opinion of the Ethical Committee of the National Transplantation Council. The decision is usually made quite quickly, because in non-litigious proceedings.

Category:

Urology and Nephrology