Minority kidney transplants could increase with new option

[Judi Lynn]

January 31, 2019

Kidney transplant recipients are now benefiting from donor organs that do not match their blood type but are compatible and just as safe, according to a Vanderbilt University Medical Center study in the Journal of the American College of Surgeons.

The study's finding is significant because roughly 15 percent of the population has blood type B, which is more common in African-Americans, and those patients have historically been transplanted at lower rates due to a lack of available organs.

The Vanderbilt study shows that blood type B patients can receive blood type A2 kidneys with similar outcomes.

Lead author David Shaffer, MD, professor of Surgery and Chief of Kidney and Pancreas Transplant, said more than 400 of the roughly 1,000 patients on the Vanderbilt waitlist for a kidney are African-Americans.]

More:
https://www.brightsurf.com/news/article/013119475226/minority-kidney-transplants-could-increase-with-new-option.html

[CaliforniaPeggy]

1. That is really significant news.

Transplants are so tricky to accomplish successfully that it's wonderful when new facts make them easier.

K&R!

[pnwmom]

2. How come if they are 15% of the population they aren't roughly the same percent of the donors?

[defacto7]

3. If I understand correctly the problem of unavailability would be

before the A types were considered viable. Now I guess there would be a better supply. The other way to see your question would be to read it as if 100% of the 15% were donors and that couldn't be true. Maybe I don't understand the question.

[pnwmom]

4. My question is why the fact that they were a smaller slice of the population would make it

less likely than with other groups that they could find other donors with the same blood types? Because if they had the same percentage of donors as in general and the same percentage of people in need as in general, then why would they have had a particular problem up till now?

Are people with that blood type less likely to be donors for reasons of health, culture, or some other reason? Or are they more likely to have diseased kidneys for some reason? What is causing their situation to be worse than other blood types?

[eppur_se_muova]

5. It's not as simple as *exactly* matching the donor type to the acceptor ...

This info is for red blood cell and plasma types, but similar principles apply:

https://en.wikipedia.org/wiki/Blood_type#Red_blood_cell_compatibility
https://en.wikipedia.org/wiki/Blood_type#Plasma_compatibility

Some people are universal donors, and donate to any other type. Others are universal acceptors, and can accept any type. Others can only donate to/accept from a limited number of types.

Sound complicated ? Well, yeah, it's all a contingent result of the various paths taken in the evolution of the human immune system.

[pnwmom]

6. Thanks!

[Igel]

7. A few reasons.

The Af-Am population has a lower donation rate than the overall average. Distrust, less education, higher poverty.

They tend to be poorer, as well, and there's still money involved with maintaining the donated organ and recovery.

Geography plays a role on top of this, organs typically are transplanted quickly, meaning they get sent regionally but not long distances.

The recipient has to pass certain health screenings, and one of them is for hypertension. There's a racial skew to hypertension in the US.

Note that even with the lower rate of Af-Am being kidney recipients, those donations more often tended to be from living donors to close relatives, so the problem was worse than the stripped-down numbers would suggest.

[pnwmom]

8. Thank you for explaining. n/t