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New Techniques Allow St. Paul's Kidney Transplant Program to Increase the Number of Compatible Donors and Save Lives
<< BACK | Download Word File Vancouver, May 10, 2006 — As St. Paul's Hospital celebrates the 20th anniversary of its first kidney transplant, patients are benefiting from innovative new procedures that can help overcome incompatibility between organ donors and recipients and reduce the risk of rejection. The story of New Westminster resident Aran Lewis provides a dramatic example of how the new treatments can increase the pool of potential donors and save lives. Lewis, 26, was born with a congenital kidney defect that required corrective surgery and kidney transplants. But his second transplanted kidney had failed and after four years of dialysis his health was deteriorating. His only hope was another transplant. His mother was willing to donate her kidney, but although she and Aran had the same blood type, they were otherwise incompatible. No other matches could be found. When Aran's situation became desperate, the St. Paul's kidney transplant team agreed to perform the surgery using promising new protocols, including "pre-treatments" that prepare the recipient for transplant. "We had never performed a kidney transplant with this degree of incompatibility before," recalled Dr. David Landsberg, Physician Program Director, Renal Program and Head, Division of Nephrology, of the surgery that took place in June 2005. "It was very high-risk, with many possible complications as well as the risk of failure." While Aran's recovery wasn't without complications, there have been no signs of rejection. He has fully recovered, was married last September and has begun to resume an active lifestyle that includes swimming and learning to play golf. "St. Paul's program, which is operated in partnership with the BC Transplant Society, is on North America's leading edge of these new pre-treatment regimes," says Dr. Landsberg. "Now, just because a possible kidney donor and recipient are incompatible, it does not necessary mean that performing the living donor transplant is out of the question. Never before have we had such a complete set of tools to address these issues." New tools available to the transplant team include a better ability to characterize and monitor harmful antibodies, advances in renal biopsy and pre-treatment medications that prevent bone marrow from producing antibodies. Such immunosuppressant drugs were first developed as cancer treatments A key technique the transplant team used pre- and post-treatment is called a plasma exchange. This was accomplished by withdrawing Aran's blood with dialysis-like equipment that separated the plasma, which carries the antibodies, from the red blood cells. Antibodies are an essential part of the immune system and normally act to protect the body. But this is a liability in the case of organ transplants, as the antibodies identify the organ as foreign tissue and attack it. The plasma exchange technique replaces the plasma with albumen. Plasma exchanges can allow an expansion of the pool of potential donors, which comes at an opportune time. End-stage kidney disease is rapidly increasing, especially among those over 65, primarily due to complications from high blood pressure and diabetes. "The number of people in BC with end-stage kidney disease requiring dialysis is growing at a rate of eight to 10 per cent per year," says Dr. Landsberg. Kidneys for transplantation are in short supply. Patients who do not have a living donor can wait five to seven years to receive a kidney from a deceased donor. The gift of a new kidney has a tremendous impact on quality of life, renewing health and liberating recipients from frequent dialysis treatments. The St. Paul's kidney transplant program has evolved over the past 20 years into BC's largest and one of Canada's finest. It operates in partnership with the BC Transplant Society, which is responsible for all aspects of organ donation and transplantation in the province. The program's achievements include performing Canada's first living anonymous donor transplant, Canada's first HIV-positive kidney transplant and BC's first minimally invasive laparoscopic surgery to remove a kidney from a living donor. More than 1,300 kidney transplants have been performed at the hospital since 1986. When the first transplant took place at St. Paul's in 1986, the vast majority of patients received a new kidney from a deceased donor. Today, more than 60 per cent of kidney transplants performed at St. Paul's come from living donors who donate to a family member or friend. BC has the highest proportion of living kidney donors in Canada. Dialysis can keep end-stage kidney patients alive for a period of time, but transplantation increases their expected lifespan by 10 years on average. For a younger person such as Lewis the benefit of a transplant is even greater, with an average increase in lifespan of 17 years. Members of the public are reminded that if they have not signed up with the British Columbia Transplant Society's Organ Donor Registry, they can add their name to the registry by visiting www.transplant.bc.ca or calling 1.800.663.6189. -30- Contact: Gavin Wilson Providence Health Care Communications Tel. 604.806.8583 E-mail: gwilson@providencehealth.bc.ca Fact Sheet Kidney Transplant Program at St. Paul's Hospital All transplant programs at St. Paul's are operated in partnership with the BC Transplant Society, which is responsible for all aspects of organ donation and transplantation in the province. The St. Paul's kidney transplant program was established in 1986 through the efforts of Dr. Angus Rae and Dr. David Manson. Dr. David Landsberg was recruited to lead the program and still holds that position. Twenty-five years ago St. Paul's Hospital had a small 12-station hemodialysis unit. In response to the increase in demand for dialysis, the hospital now has a 43-station unit and operates an additional six community dialysis units in Vancouver, Richmond, North Vancouver, Powell River, Squamish and Sechelt. Achievements of the St. Paul's kidney transplant program:
Number of patients in BC:
Total BC transplants completed Jan - Dec 2005
The overall five-year survival rate for dialysis patients is worse than all cancers, except lung. General Kidney Disease Information Most people have two kidneys. They are located on either side of the spine under the lower ribs. The kidneys perform many functions. The most important of these are:
Sources: BC Transplant Society, Provincial Renal Agency, Kidney Foundation of Canada (BC) << BACK | Download Word File |
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