Media Release

Davorin receives first Australian incompatible blood group kidney transplant

13 July 2006     In an Australian first doctors at The Royal Melbourne Hospital have successfully performed a kidney transplant across incompatible blood groups. The recipient, a young Melbourne man, Davorin Gelemanovic, 24, is now leading a normal life after having been ill for several years and needing dialysis treatment for about 12 months. Kidney transplant specialist, Dr Shlomo Cohney, who coordinated the team involved in this ground breaking transplant performed in December last year, said there were no signs of rejection - more than six months after the transplant. Dr Cohney said until recently this kind of transplant was thought impossible or too risky, with obstacles similar to those involving incompatible blood transfusions.

After years of illness, 24-year-old Davorin Gelemanovic (right) and his father Steve reflect on how Davorin’s life has changed since he received a new kidney.

"Normally, a kidney donor has to have the same blood group as the recipient or a blood group that is acceptable," he said.

"Most people have natural antibodies against blood groups other than their own. Kidney transplants into patients with a different blood group have previously resulted in very rapid severe rejection and destruction of the kidney within hours or days by a process known as acute rejection."

The success of this transplant was due to the combination of several factors, Dr Cohney said.

"Careful measurement and monitoring of the patient's antibodies and the use of new medications, combined with techniques to remove antibodies from the patient's blood were important ingredients in our success.

"In addition, for the first time in Australia, we used a new device to remove blood group antibodies without removing other antibodies or important proteins."

Dr Cohney said until now blood group incompatible kidney transplantation had been avoided in Australia because of the high risks involved.

"If done it required the removal of the patient's spleen at the same time as the transplant and the administration of extremely high levels of medication to stop the body's immune system rejecting the kidney," he said.

"A splenectomy is a big operation in itself and with the drugs previously required, it increased the risks of complications significantly. Even with these steps the risk of losing the transplant early was still much greater than in the case of a normal transplant," Dr Cohney said.

This new option for patients with kidney failure was an additional boost to The Royal Melbourne Hospital's existing program for patients with other kinds of antibodies that cause rejection.

An increase in live donor kidney transplants, a reduction in transplant waiting time and fresh hope for kidney dialysis patients waiting for a transplant, were some of the possible consequences of this major development in kidney transplantation, said Dr Cohney.

"Live renal transplantation is one solution to growing waiting lists, but until now up to 35 percent of potential live donors have been unable to donate because of blood group incompatibility with the intended recipient.

"However, we should not lose sight of trying to improve on the very low Australian organ donation rate that still leaves one person dying every week while waiting for a kidney transplant," he said.