transplant inquiry

[dfk]

this may be redundant and newbish,
but the other day i was doing liver/renal transplant, and i overheard the coordinators say that this 31 yr old female was a 13 zero match.
i didn't ask at the time, but should have.
doesn't sound good.
thoughts/responses?
any clarification is appreciated.

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[core0]

this may be redundant and newbish,
but the other day i was doing liver/renal transplant, and i overheard the coordinators say that this 31 yr old female was a 13 zero match.
i didn't ask at the time, but should have.
doesn't sound good.
thoughts/responses?
any clarification is appreciated.

Short answer is you probably heard wrong. The other short answer is that mismatch status doesn't matter in Liver/Kidney transplants. The thought is that the liver protects the kidney from rejection. There are isolated case reports of kidneys rejecting without the liver rejecting, but in the great majority of the cases the liver rejects before the kidney. You just match the blood type and go. If you get really desperate you can do it without matching the blood type (works better in kids than adults though).

Mismatch in kidneys occurs when the HLA antigens do not match. There are six HLA antigens that are tested. The best is six out of six. The worst is zero out of six. However in kidneys the worst living donor is better than the best cadaveric donor. Here is a good explanation:
http://www.livingdonorsonline.org/HLAData.htm

Our lab is testing other antigens to try to expand the matching criteria so its possible that somebody reported 13 HLA antigens. Not very useful though. A number of labs have also looked at HLA mismatch in livers and found no difference in graft or patient survival.

David Carpenter, PA-C

 

[dfk]

hey david,
thanks for some clarification.

i did however hear them say, after getting off the phone from someone/somewhere, "she's a 13 zero match".
that's why it stuck in my head.

if i get another chance, i'll ask the CDT people.