Waiting Lists and Revved Up Immune Systems

I learned something new today. I was speaking with the coordinator of the Multi-Organ Transplant Program here at the London Health Sciences Centre. We talked about what it means to be on the deceased donor list, the possibilities of the Living Donor Paired Exchange program, and my physical capacity to accept a transplanted organ without rejection.

Except in the case of identical twins, every organ recipient needs to take anti-rejection drugs following a kidney transplant. I knew already that as someone with Type O blood, I need to have a Type O donor. What I wasn’t fully aware of before was that different individuals have different levels of immune sensitivity. Usually, heightened sensitivity, or a “revved up immune system,” is the result of a previous organ transplant, a blood transfusion, or pregnancy. The last one is ruled out, clearly, and to my knowledge I’ve never had a blood transfusion or other organ transplant, so it’s not clear why my immune system is the way it is, except that I have been told that my kidney disease, membranoproliferative glomerulonephritis, is itself a result of the immune system going wrong and attacking my kidneys. No one has drawn that connection for me, yet, though.

So, how revved up is my immune system? The way it was described to me was as follows: If I have ten potentially compatible donors and my immune sensitivity is such that I could accept a kidney from all ten, then I have an immune sensitivity of 0%. If on the other hand, there was a high likelihood of rejection from all ten, my immune sensitivity would be 100%. Mine happens to be 53%, more or less in the middle.

What does that mean? It means that it might be a little more difficult for me to get a donated kidney than I had previously thought, resulting in more time on the waiting list and more time on dialysis. It also emphasizes the value of people signing up online as organ donors. In Ontario, go to https://beadonor.ca/.

I’ll close with a graphic showing the situation for those needing donated organs in 2012. It’s a bit dated, but the situation is not markedly different.



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