Incompatible Living Donor Programs

The Adult Kidney Transplant Program at Massachusetts General Hospital provides solutions for patients with incompatible living donors, including positive cross match and ABO-incompatible donors.

Chief of the Transplant Division James F. Markmann, MD, PhD, speaks with a patient

Chief of the Division of Transplantation James F. Markmann, MD, PhD, consults with a patient

Desensitization Protocols

Some patients awaiting kidney transplant may be unable to receive a kidney from a living donor because of a “positive cross match.” A positive cross match can result from antibodies produced by the recipient following pregnancies, blood transfusions or prior transplants. The Mass General Adult Kidney Transplant Program has an effective protocol in place to clear these antibodies from appropriate candidates. After additional blood testing, medications and treatment, a final evaluation determines if the transplant can take place safely. Close follow-up after transplantation is required.
ABO-Incompatible Kidney TransplantationSome patients awaiting kidney transplantation may have an ABO-incompatible living donor. This means that the organ recipient has normally occurring antibodies against blood group antigens carried by the donor. A kidney transplanted under these circumstances would normally be rejected and destroyed by the recipient’s immune system but the Mass General Adult Kidney Transplant Program has established strategies to remove these antibodies from suitable candidates, making it possible to perform a transplant safely. This program involves blood testing, medications and treatments in addition to the standard kidney transplant evaluation, and close follow-up after transplantation.
National Kidney RegistryMass General participates in the National Kidney Registry, an independent organization that facilitates transplants for patients with incompatible living donors, and for antibody, blood type, size and age issues. A computer program finds suitable donors from other mismatched pairs in the Registry, and identifies the necessary exchanges needed to allow all corresponding recipients to be transplanted from a suitable donor. Patients may be part of a multi-pair chain that results in several recipients being transplanted across many states.

To learn more about the National Kidney Registry, visit the Registry's website or call the Mass General Adult Kidney Transplant Program at 877-644-2860
United Network for Organ Sharing (UNOS) Paired Kidney Exchange ProgramMass General can register patients with incompatible living donors in the United Network for Organ Sharing (UNOS) Paired Kidney Exchange Program, which works to expedite transplants in patients with blood group antibodies or other incompatibilities to their potential living donors. Read more about UNOS.

 

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