Incompatible kidney transplants a reality in Wellington

17 October 2019

Patients needing incompatible kidney transplants no longer need to travel to Auckland or Christchurch thanks to close collaboration between the Renal Service and the New Zealand Blood Service (NZBS).

ABO-incompatible (ABOi) kidney transplants are between a live donor and recipient with different blood types, and can now be performed in Wellington.

“They involve increased immune-suppression and pre-operative care, and are a balancing act avoiding organ rejection against the risk of infection,” said Renal Services consultant Dr Grant Pidgeon.

“Historically we sent donors and recipients to Auckland. This could be difficult as they need to spend a lot of time there and it wasn’t easy for families and whanau to support them.”

To counter this the service developed protocols, collaborated closely with NZBS, and performed its first ABOi transplant in July.

“We already undertake the tasks involved in ABOi transplants while supporting patients with other procedures. However the time-critical nature and intensity of support is much greater, requiring careful planning and increased flexibility,” said NZBS Blood Bank team leader Dan Gyles.

Part of that support is carrying out numerous and repeated ABO Antibody titrations.

“Each titration involves more than 100 hand-labelled test tubes and is carried out to establish the strength of the recipient’s antibody to the donor’s blood group and ensure it is below the acceptable threshold,” said CCDHB haematologist and NZBS transfusion medicine specialist Dr Michelle Dickson.

The NZBS also performs plasma exchange procedures in the week leading up to the transplant and – as with all surgeries – provides transfusion components and products as required.

“Although only two or three patients require ABOi renal transplants a year, the move is still reasonably significant,” said Grant.

“We’re very pleased that, thanks in large part to the great collaboration with NZBS, we’re now able to offer these transplants to and make it easier for patients throughout our region to access these transplants closer to home.”

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