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Research Improves Kidney Transplant Chances for Sensitized Patients

Approximately one-third of the patients on the national waiting list for kidney transplants have only a small chance of receiving// a new organ, no matter how long they are on the list. Due to prior transplants, pregnancies or blood transfusions, these patients have developed antibodies that make it very difficult to match them with donor organs.

Researchers at Emory University have developed a decision process, based on innovative technology, that may help to level the transplant playing field and give new hope to these "highly sensitized patients." The Emory Algorithm, as this new method is known, may even change the way kidneys from deceased donors are allocated in the United States.

Sensitized patients have developed antibodies against human leukocyte antigens (HLAs), which play an important role in the body's immune response to foreign tissue. These patients represent one-third of the national waiting list for kidney transplant patients (50 percent in Georgia), but they only receive about 15 percent of deceased-donor kidney transplants each year.

The United Network for Organ Sharing (UNOS) coordinates the nation's transplant system through a point system based primarily on wait time, sensitization and HLA matching. When a "perfect match" occurs, the kidney is offered to the person at the top of the national list. If there are no perfect matches nationally, the kidney becomes available to transplant centers in the region from which it came.

The Emory Algorithm, while still following these guidelines, allows a transplant center to predict which sensitized patients on the list will be compatible with any given donor. A five-year Emory study, published in the October 2006 issue of the American Journal of Transplantation, found the algorithm raised the rate of transplants from 15 percent to 25 percent in sensitized patients by accurately predicting which of these patients would be compatible with the donor kidney. Th
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