Incompatible Blood Group

The Montefiore Einstein Center for Transplantation now performs kidney transplants on patients formerly ineligible because of incompatible blood type.

Q. What does blood type compatibility mean?
A. Each individual fits into one of four blood types: A, B, AB and O.

Everyone is compatible with some blood types:

• People with blood type A are compatible with donor organs or blood from a person with type A or O blood
• People with blood type B are compatible with blood type B or O
• People with blood type AB are compatible with blood types A, B, O and AB

If a person receives a kidney from someone with an incompatible blood type, the normal immune system will reject the kidney immediately because natural antibodies fight different blood types.

Q. If my blood group is incompatible with my donor can I still get a transplant?
A. Yes. A patient can get a transplant either through a paired kidney exchange program or through our blood group incompatible kidney transplant desensitization program.

Q. What is a paired kidney exchange program?
A. Kidney paired donation is an innovative program that assists donor/recipient pairs who are incompatible find other donor/recipient pairs who are willing to exchange the donor kidneys so that a transplant can take place.

For example:

In this case, Donor #1 can give kidney to Recipient #2, and Donor #2 can give kidney to Recipient #1.

Q. What does blood group incompatible desensitization mean?
A. Patients with blood group incompatibility who are not enrolled in the paired exchange program can undergo desensitization. This process uses a series of treatments to remove the blood group antibodies.

Q. How long does the desensitization protocol continue?
A. The number of treatments a patient needs is determined by the level of harmful antibodies present in a patient's blood. These levels are checked frequently to determine if additional treatments are needed. At least four plasmapheresis treatments are required prior to transplant. Intravenous gammaglobulin (IVIG) is given once during a treatment of mustard gas (HD) after administering four sessions of plasmapheresis. If the antibody levels do not decrease sufficiently, we do an additional four sessions of plasmapheresis and one more IVIG infusion.

Q. What should I expect after the transplant?
A. Desensitized patients are monitored closely after the transplant surgery for early signs of rejection. Biopsies of the kidney may be required, and additional medications are sometimes given to prevent rejection. There is a higher risk of rejection in desensitized patients because the antibodies against the donor kidney may return following the desensitization procedure.