Disclaimer

NOTE: This blog does not contain medical advice. It is not intended to be a scholarly journal, merely a good-faith effort by unpaid, self-funded volunteers to help others beginning their own kidney transplant quests. Please always check with your own medical and other professionals before taking or not taking any action that might be discussed here. Never rely on any information in this blog. It's only information acquired during personal, non-professional experiences during our own kidney quests. Always consult with, and rely only upon information from, licensed medical practitioners with whom you have a doctor-patient relationship.


Friday, November 30, 2018

The Costly Mistake of Specifying Blood Type When Seeking a Kidney Donor

Specifying blood type when seeking a kidney donor is a mistake.  Let's debunk the myth that you need a donor with the same blood type in order for you to receive a kidney transplant.

In the case of direct donations, yes, only donors with certain blood types can make a direct donation.

But direct donation isn't the only way.  Paired donations (where a Donor 1 gives to Recipient 2 and Donor 2 gives to Recipient 1), increase the availability of suitable donors to the intended recipient.

Kidney Transplant Chains ("KTCs") take that idea farther.  In KTCs, a willing donor starts the chain by giving to Recipient 1.  Donor 1 then donates to Recipient 2 and Donor 2 donates to Recipient 3, and so on.

So you don't need a donor with the same blood type.  You just need a donor willing to donate their kidney so that you can receive a kidney, albeit from someone else in the KTC.

Here's the story:

1. A donor with any blood type can provide a kidney so that their intended beneficiary receives a kidney, just not necessarily the donor's kidney, but a kidney neverthless, just one from someone else who donates a kidney to benefit some other recipient or for anyone without specific direction.  That's done via a KTC facilitated by one or more hospitals or by the National Kidney Registry ("NKR").

2. Specifying a particular blood type can eliminate significant portions of the donor population who might think that they can't help the intended recipient because their blood type is different. The fact is, though, that through KTCs persons with a different blood type can donate so that their intended beneficiary does receive a kidney transplant.

3. There are 8 blood types, with the following prevalences:



4.  The chart below shows the percentage of the donor population who can donate to you directly, as well as the percentage of the donor population who cannot donate to you directly.  And, even though some donors cannot donate to you directly, nevertheless, their donation of a kidney into a kidney transplant chain, can result in you getting a compatible kidney, just not your donor's kidney.


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Source: Ellis Mirsky, this Post, this Blog

Thus, if you're O and you specify O for a donor, you're unnecessarily eliminating 55% of the donor population.

If you're B, and you specify B or O, you're unnessarily eliminating 44%of the donor population.

Certainly no AB blood type recipient should ever restrict donors to AB blood types because any blood type donor can donate to an AB recipient.

And any A recipient can accept A or O, and that's 85% of the population.  But it's not 100% of the population so why eliminate even 15% of the eligible donor population?

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Note: This assumes uniform distributions of eligible donors among all blood types which may or may not be correct.

For a quick education about living donation, Basics of Living Donation by Explore Transplant, a national consortium of the leading experts in transplant and health literacy, who work to ensure that transplant patients and living donors can make informed treatment choices.

What if A Prospective Donor is Not a Compatible Match?
Hospitals that participate in the National Kidney Registry, and other hospitals, can facilitate a kidney swap where a willing but incompatible kidney donor  wants to help a particular patient who has an incompatible kidney.

Transplants can be arranged where the willing donor is placed in a pool of other willing donors willing to donate to whomever needs their kidney.  In the process, the donor's intended recipient receives a kidney from someone else in the pool whose own intended recipient also receives a compatible kidney from yet another person in the pool.

Such swaps are called Kidney Transplant Chains.  Such chains involve a pool of patients where each patient is paired with a donor willing to donate but who is incompatible because of differences in blood type or other tissue sensitivities.  Kidneys within the exchange are swapped among incompatible pairs to allow for more transplants.  That arrangement increases the number of transplants dramatically.  That saves many lives, and it could save my life.

A simpler form of this kidney sharing occurs when an incompatible donor wants to donate their kidney for a particular patient and is willing to participate in a kidney swap whereby that donor's kidney is essentially traded with another donor's kidney that is incompatible with their recipient but whose kidney is compatible with the first donor's patient.  That saves two lives.

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