There is new hope for highly sensitized patients that have been waiting years for a kidney transplant, thanks to the new Highly Sensitized Patient (HSP) program.
“A ‘highly sensitized’ patient is someone whose immune system is very reactive, such that very few donors will be a match,” said Kathryn Tinckam, medical advisor in transplantation for Canadian Blood Services. “The way they become highly sensitized is by being exposed to foreign transplants, blood transfusions, or pregnancy.”
These causes usually imply that females tend to be more highly sensitized than men because of pregnancies, but men can also be included if they’ve had prior transplants and transfusions.
According to transplant nephrologist, Dr. Rahul Mainra, there are also different levels of sensitivity. As such, only patients with a sensitized rate of 95 per cent or higher qualify for this program. This means that they would only a one in 20 chance of being compatible with a donor. For patients with a 100 per cent sensitized rate, their chances are as low as one in 1,000.
“The challenge is to be matched because they already have a limited number of donors they can be matched to,” said Mainra. “In a small province like Saskatchewan with a low number of donors, (finding the right kidney) for some patients would take forever.”
According to the Canadian Organ Replacement Register (CORR), in 2013, 1,419 kidneys were transplanted. By the end of the same year, there were still 3,277 people waiting for a deceased kidney transplant. As of May 11 of this year, there are 456 patients on the national HSP registry, meaning many of them have already been waiting years for a new kidney.
With the implementation of the HSP program, the chances of finding the right kidney for these patients has been broadened to the national level. The program was first piloted in Saskatchewan and Manitoba in October 2013. By November of last year, all provinces and territories had joined. To date, 111 patients have been given kidney transplants thanks to the program, of which four were from Saskatchewan.
“The Saskatchewan government was very supportive of collaboration with (Canadian Blood Services), who were in charge of putting together this program,” said Erin Schimpf, provincial program manager of the Saskatchewan Transplant Program. “We’ve been very pleased with the work that’s gone on nationally and I think it’s doing great things for the patient and nationally.”
Despite all the success the program has been seeing so far, there is still one major roadblock that hinders their work: lack of donors.
“There’s a lack of awareness about organ donation. There aren’t enough donors, which is why we still have a wait list,” said Tinckman. “There have been enormous efforts to increase education and awareness, but we still have a lot of work to do.”
