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Transplant first gives hope to children

August 18, 2013 Amy Corderoy

The waiting list for children in desperate need of a kidney transplant could be slashed by a third after a pioneering procedure at Sydney Children’s Hospital.

For the first time in Australia, a child has been given a kidney transplant from a donor who does not match their blood type, opening the door for many more parents to donate organs.

Chelsea Bury, 14, received a kidney from her father, Nigel, just over a week ago at the Sydney Children’s Hospital and Prince of Wales Hospital in Randwick.

Dr Lennnox explains the procedure, using an illustration. The old kidney will not be replaced – The new kidney will fit into another location. Photo: Jenny Evans

Fiona Mackie, the head of the department of nephrology at Sydney Children’s Hospital, said up to a third of children who needed a transplant had blood that was incompatible with their parents’, so, in the past, could not receive their organs.

”In general most parents want to donate to their children, and being blood-type incompatible is the most common reason that they can’t,” she said.

”We can’t know for sure how many more parents will be able to donate but it could potentially be up to a third.”

Living organ donation rates have fallen in Australia, down from 42 per cent of all kidney donations in Australia in 2009 to 31 per cent in 2011.

At the same time, the children’s waiting list has increased.

Dr Mackie said she had initially told Chelsea she would have to go on dialysis while she waited a year or 18 months for a kidney through the deceased donor system. ”But Chelsea had a difficult time on dialysis … and we started thinking of other options,” she said.

To be able to accept her father’s kidney, Chelsea had to undergo treatment that removed the plasma from her own blood and replaced it with plasma that did not contain antibodies which would cause rejection.

Dr Mackie said the procedure had been ”really intense” for the medical and nursing staff, as well as for Chelsea. But she was already ”looking great”, and on Saturday she was discharged from hospital, only nine days after her surgery.

The procedure was so successful the group was already preparing to perform one on a different child.

Kidney Health Australia medical director Timothy Mathew said the transplant was very exciting.

”Live donation is far and away the best option both for the child and the adult,” he said.

Recent figures indicated people who received live transplants had a 21 per cent better survival rate after 20 years than people who received transplants from deceased donors.

Australia and New Zealand Dialysis and Transplant Registry executive officer Stephen McDonald said non-blood-matching kidney transplantation had been performed on adults in Australia since about 2006.

There were between 230 and 250 living kidney donations each year, with 30 to 40 of those using non-blood-matched donors.

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