Tuesday, May 21, 2013

Kidney Quest: Matching

Within a week, as promised, we had the initial results of the typing. The first measure--blood type.

Prior to the "Results Show," the DeFord audience had elected Bob by a vote of 5-1 (guess who had been the lone dissenter?). Only those with A+ blood needed to apply, as that matched Alan. Only Art and I qualified.

I was in the bottom half of the match. On a six point scale, art was a four. I scored a two. Thinking two was too low, Susan Siriwatana, our case manager, assured me successful transplants happened with a zero score. (Which, I proudly announce, I am not, never ever have been a zero).  The first determinant is the blood type. However, it does not mean you are a match, but you can be considered.

Our tissue typing would be repeated later in the matching process, within a week of the surgery, because compatibility levels an change.
HLA-A1 (Photo credit: Wikipedia)

The Matching Process:
  1. Donor and recipient need the same Human Leukocyte Antigens (HLA). These are proteins on the surface of the white blood cells and tissues in the body. Siblings have a 1 in 4 chance of being identical matches. Just because you share blood type doesn't mean you share the HLA.
  2. Matched for specific immune reactivity. This checks to insure the recipient, in this case my brother, had the antibody toward my tissues. (How could he?) Antibodies are use to fight off foreign bodies such as bacteria, viruses and stray kidneys. The antibody will only injure the donor if he has the specific antibody to the donor's particular HLA. You are looking for a negative cross-match.
  3. HLA antibodies can come and go. The Percent Reactive Antibodies (PRA) needs to be retested within a week of the surgery. The PRA is determined by testing the recipient's serum to sixy types of HLA.
Thankfully, Susan knew this was more information than we needed. For us, I knew I only ranked a 2/6 and had five years to make a decision.

Or so I thought.

More later.

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