Kidney Transplant Today
May 2021
Ryan Elbert lives near Milwaukee and is married, happy, and hoping to soon start a family. However, his high school years in St. Louis were not so enjoyable. Elbert was diagnosed with end-stage renal failure in 2005. The kidney condition required dialysis, and the ongoing treatment was emotionally and physically draining.

“Every ounce in your body, every cell in your body feels like it is attacking you for doing this to it,” Elbert said. “It’s an extremely, extremely tiring process to go through dialysis.”

Elbert was a patient at SSM Health Cardinal Glennon Children’s Hospital. Erin Foristal, the transplant coordinator at the hospital, helped watch over Elbert when he was a patient.
“He missed out on a lot of high school fun,” Foristal said.

When Elbert turned 18, he was still in need of a successful transplant. Adults often have longer wait times for a donor. Foristal decided to ask Elbert if he would let her donate one of her kidneys. Foristal and Elbert underwent successful transplant surgery at SSM Health St. Louis University Hospital.

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The UW Health Transplant Center performed 64 paired kidney exchanges last year, which the organization said Tuesday was more than any other transplant center in the country.

That is on top of UW Hospital giving organ transplants to a record 548 patients last year, including a record 315 people who received kidneys, even though the COVID-19 pandemic led doctors to shut down elements of the transplant program for parts of the year.

Paired kidney exchanges allow people who need kidneys and their willing but mismatched living donors to swap organs with other incompatible pairs to find suitable donors for the recipients.

Paired kidney exchanges can improve overall transplant quality and reduce waiting times for patients needing kidney transplants, studies show. UW Health does pair kidney exchanges through the National Kidney Registry, which facilitates more than 450 paired kidney exchange transplants annually.

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Looking to improve organ transplant success, researchers are working to learn more about how an immune molecule, which also protects a fetus, helps protect some transplanted kidneys, and to develop a synthetic version of that molecule that could help more patients.

They also are working from the other direction with a “humanized” mouse model that could better select the optimal organ donor and reduce rejection risk. The molecule is HLA-G and it’s part of the usual checks and balances that keep our immune system focused on invaders like cancer or a virus and not attacking our own tissue.

Medical College of Georgia investigators, led by Dr. Anatolij Horuzsko, an immunologist in the MCG Department of Medicine and Georgia Cancer Center and a leader in the study of HLA-G, have shown that in the lab and in transplant patients a key difference between many who have long success with a new kidney and those who reject is inexplicably high levels of HLA-G. In this case, it’s a particularly potent version called HLA-G dimer, which is essentially two of the immune molecules bound together.

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