What is an incompatible kidney donation?

More than one-third of willing live donors are turned down because their blood types are not compatible with the person to whom they wish to donate their kidney. The reason it can be dangerous to transplant an incompatible kidney is most of us have natural antibodies against organs from people with different blood types. These antibodies can rapidly destroy a transplanted kidney.

However, an incompatible kidney donation program like the one offered at Johns Hopkins allows patients to receive a kidney from a live donor who has an incompatible blood type. Patients in this program must be willing to undergo all prescribed treatments before and after the transplant to remove harmful antibodies and decrease the risk of rejection.

Harmful antibodies are removed with a process called plasmapheresis, a procedure similar to dialysis that removes the plasma portion of the blood where antibodies are located. The number of plasmapheresis treatments required by the recipient before surgery varies depending on the amount of harmful antibodies in their blood.

After each plasmapheresis, the recipient receives an intravenous infusion of immune globulin to replace antibodies needed to fight infections and help prevent harmful antibodies from returning. Once the antibodies against the donor’s blood type decrease to very low levels, the transplantation can take place.