New program gives patients hope to find a kidney match
Eileen Williams waited for a kidney transplant for 15 years. In April, she got one. Williams, 64, is one of the unlikeliest kidney transplant recipients. She is considered a “highly sensitized patient” because her immune system has developed antibodies to 95 per cent of the Canadian population. This means it is extremely difficult to find a kidney match that her immune system won’t reject.
But thanks to a new program led by Canadian Blood Services in collaboration with provincial donation and transplantation programs across the country, other patients like Williams who have been waiting for a transplant for 10 to 20 years may finally find their kidney match too.
The Highly Sensitized Patient program takes patients “least likely to be given a kidney offer and makes them eligible for any potential donor across the country,” says Dr. Lee Anne Tibbles, medical director of the southern Alberta Transplant Program.
The national organ-sharing program pairs the kidneys of deceased donors to those who typically wait the longest for a transplant because there are so few eligible matches in their local region or province.
“When people are exposed to other people’s tissues, they develop antibodies or become sensitized to those tissues,” said Dr. Tibbles. She explained that those antibodies can detect organs which are “different” and reject them.
“So when people are exposed to blood transfusions or previous transplants or pregnancies, they develop antibodies to other people’s tissues, which then make it very difficult to get a good tissue-typing match for a kidney for them to get transplanted,” Tibbles said.
“The more antibodies you make, the more sensitized you become, the more likely it is to have rejection after transplant.
The program chooses kidneys for patients to which their antibodies have not yet developed a sensitivity.
It was launched Friday by Alberta Health Services at the Foothills Medical Centre. National implementation of the program began in October 2013 and all provinces and territories signed on by November 2014. It has already led to 111 kidney transplants, including seven in Calgary and four in Edmonton.
Williams received her first kidney transplant in 1989 after her own had failed. That transplanted kidney lasted 11 years, and as a highly sensitized patient, she was left waiting for 15 years on dialysis treatment.
“I think you have to condition yourself because you have to tell yourself, ‘This is what I have to do in order to survive,’ so you do. You follow a strict diet and you dialyze three times a week,” Williams said. “That becomes your life.”
There are 23 highly sensitized patients like Williams on the waiting list for the program in Calgary. Tibbles said dialysis therapy has a yearly mortality rate of 10 to 20 per cent, which accumulates over time.
Some patients wait so long that they then become ineligible for transplantation because of other illnesses.
“Life on dialysis is not comfortable,” Dr. Tibbles said. “This gives them real hope for a transplant in the not-so-distant future.”
Williams says she feels “totally different” since her April 1 surgery. She said she doesn’t know who her donor is, but that she is grateful.
“I figured this is my only chance. You develop such high sensitivity that it’s hard to find a match,” Williams said. “I thank God for it every day.”