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Jerry Schueler |
“My kids finally said, ‘Dad, we’re just going to give you one of our kidneys and be done with it.’ But I told them I’d rather take a kidney from a cadaver than from one of my children,” Schueler said.
Schueler’s youngest son didn’t listen to that request. He went to The Nebraska Medical Center to find out whether he could be the kidney donor for his father.
“He was very disappointed when he found out our blood types were incompatible,” said Schueler. “But that’s when doctors asked me if I wanted to be the first patient to receive a blood type incompatible kidney transplant at The Nebraska Medical Center.”
One year ago this month, in July 2005, Schueler received his transplant. He’s doing well and has had no signs of organ rejection. Since then, there have been two other successful blood type incompatible kidney transplants at The Nebraska Medical Center.
Transplant patients historically have needed a compatible blood type donor because the natural antibodies (blood proteins) most people have would destroy an organ from someone of a different blood type. But by filtering the blood of antibodies and giving patients a medication that prevents the antibodies from coming back, doctors at The Nebraska Medical Center are crossing these barriers. The combined treatment has been successful for patients who are considered “ABO incompatible” meaning their blood type – A, B, AB or O – differs from their donor.
“Many of these patients have repeatedly been told the wait is three to five years depending on blood type for a kidney transplant. With this program, I can tell any patient who has a living donor and is medically eligible that they can be transplanted with a high likelihood of success,” said Lucile Wrenshall, M.D., co-director of the Kidney-Pancreas Transplant Program at The Nebraska Medical Center and associate professor at UNMC.
This procedure gives more patients the opportunity to receive a living donor kidney, Dr. Wrenshall said.
“The blood type incompatible transplants have a similar success rate as the blood type compatible transplants as long as proper treatment is given ahead of time,” Dr. Wrenshall said. “Any transplant from a living donor means there is a better chance of the organ still functioning many years down the road than transplantation from a cadaver donor.”
“It gave me my life back again,” said Lance Bower of Ashland, the second patient to receive the blood type incompatible kidney transplant at The Nebraska Medical Center. “Living life on dialysis was very rough. I felt like I was deteriorating fast every day and I didn’t want to wait for my name to come up on the transplant list.”
That’s the same reason Bill Prokopf signed up for the blood type incompatible kidney transplant program. His brother Bob wanted to donate one of his kidneys before he returns to Iraq with his Nebraska Army National Guard Unit.
“He’ll do anything for anybody. I love him to death,” said Bill Prokopf, the kidney recipient.
The Bellevue brothers underwent surgery on June 16 and are recovering at home. Bob, a sergeant first class in the Guard, is still hoping to deploy with his unit in August or September. “I don’t want them to go and fight while I’m sitting back home,” he said. “These are my guys.”
The blood type incompatible transplant requires a specialized process. Prior to surgery, the soon-to-be recipients go through an average of three to four plasmapheresis treatments every other day starting a week to 10 days before transplantation. Three additional treatments are needed in the week after surgery.
During plasmapheresis, the fluid part of the blood, called plasma, is removed from blood cells by a device known as a cell separator. The separator works by spinning the blood at a high speed to separate the cells from the fluid. The cells are returned to the person undergoing treatment, while the plasma, which contains the antibodies, is discarded and replaced with other fluids. Due to the frequency of the treatments and the medications needed for the procedure, the cost of a blood type incompatible transplant is much higher than a normal, blood type compatible transplant. Insurance companies are not always willing to cover the additional expenses.
“So many more people can benefit from this type of procedure,” Schueler said. “What helped me decide to have a blood type incompatible transplant is after I met a man who had been doing dialysis for eight years. I thought someone has to be first, someone has to be the guinea pig so others like this man can see that there are alternatives to waiting for your name to come to the top of the national kidney waiting list.”
Of the nearly 92,000 candidates who are on the national transplant waiting list, more than 67,000 people are in need of a kidney, reports the United Network for Organ Sharing.