New Blood-Cleaning Procedure for Transplanted Kidneys

A novel blood-cleaning device for kidneys and patients scheduled for transplantation will allow patients to receive the organ from a donor with a different blood type.

The Glycosorb ABO is a medical device that facilitates blood group (ABOi) incompatibility transplantations when the donor’s blood type is not compatible with the recipient. The product is designed to reduce specifically the proportion of antibodies directed against blood group A or B; the proportion of these antibodies is relatively low, typically less than 1% of the total amount of antibodies. When the donor is blood type A, Glycosorb-ABO A-column is used, and if the donor is blood type B, Glycosorb ABO B-column is used. Repeated tests have shown that the columns are specific and do not significantly affect other blood components such as coagulation factors, immunological proteins, or the total antibody content of blood plasma.

The kidney donor is admitted to the transplant unit one day before the surgery. The recipient, on the other hand, is admitted to the unit a few days before the planned transplantation, and undergoes three consecutive treatments with Glycosorb-ABO for removal of blood group antibodies directed against the transplanted kidney. The concentration of these antibodies is monitored daily, before and after each treatment, and needs to drop to a certain level. At the same time immunosuppressive medication is started. If the patient undergoes dialysis, this continues in parallel. Glycosorb-ABO is supplied sterile with no added conservatives, and each column is approved for single use only; a new unused column is therefore used at each treatment.

The operations are done simultaneously in two different operating rooms so that the kidney is without circulation as short a time as possible. Post-operative care includes continued treatment with immunosuppressive medication and treatment with Glycosorb-ABO a couple of times if necessary. During the procedure, the concentration of antibodies towards the donor organ is constantly monitored; in general, this remains at a low level. Most patients can then live a completely normal life, with frequent check-ups. Eventually these check-ups are reduced to 3-4 times per year, with immunosuppressive drugs being given in very low doses. The Glycosorb ABO is a product of Glycorex Transplantation (Lund, Sweden), and has received the European Community (CE) marking of approval.

“The procedure could expand the number of living organ donors. More than one-third of potential live donors are turned down because their blood types are not compatible with the person to whom they wish to donate their kidney,” said Jeff Zaltzman, MD, director of the kidney transplant program at St. Michael's Hospital (Toronto, Canada), which performed the first Glycosorb ABO procedure in North America. “Every time you have a living donor, you're helping someone who would otherwise be on a transplant waiting list for a long time. That's also one more person who is not taking an organ from a deceased donor, which could then be given to someone else.”

Related Links:
Glycorex Transplantation
St. Michael's Hospital