The Transplant Team at Stony Brook University Hospital (SBUH) continues to look for ways to offer kidney transplantation to as many patients as possible as the preferred form of renal replacement therapy for patients with kidney failure. Two factors can limit the opportunity for a live donor kidney transplant. One is if there is not a suitable donor of the same or compatable ABO blood type. Another factor is if the transplant recipient has formed antibodies from a previous transfusion, transplant or prenancy that makes matching difficult. At SBUH, a protocol has been developed to reduce the levels of antibodies in patients and modulate the immune system with a combination of monoclonal antibody plus immunoglobulin and plasmapheresis treatments to allow safe and successful kidney transplantation in patients with high antibody levels and where the ABO blood type is not considered traditionally compatable. This allows us, in carefully selected situations, to overcome these biological barriers. In other situations, SBUH has joined an organized effort to pursue live paired donor kidney exchanges. Here doctors try to match people who need a kidney transplant and have a live donor with a bioological barrier to relatives or friends who are potential donors for other transplant seekers with a similar problem to see if a kidney exchange is feasible.
To date we have performed several successful ABO incompatable donor transplants, as well as positive crossmatch kidney transplants.