What is antibody washing? Don’t hold your breath! Because at the moment health authorities are refusing to support it. Antibodies are part of our natural defence against infection. We are all born with a wide range of antibodies to fight off infection, but if we see particular infections we produce an antibody response just against that. That’s why vaccination works.

There are two types of antibodies you can get that would react against a kidney transplant. One of them is blood group antibodies, and the other is tissue type antibodies. It is quite a big problem - one in five people waiting for a transplant have got tissue type antibodies. In addition about one hundred transplants a year in the UK from living donors are prohibited by antibodies. There is another background to this - the annual rate of kidney transplantation per million population in our centre here at Walsgrave against the rest of the UK. Around the country if all the units got up to about our rate you would be doing another 2-3,400 living donor transplants a year.

The treatment is physically more stressful than having an uncomplicated transplant, so if you have a lot of medical complications sadly it may not be suitable. We do antibody-washing three or seven times before the transplant. Then after the transplant you do more antibody washing. There are several different machines you can use for antibody washing, this is a picture of one. Superficially it looks rather like a dialysis machine, except it has got two filters, while a dialysis machine has only got one.

This is a very high intensity specialist treatment. There are only two centres in the UK that have done more than one, and there are only a couple of places that have actually done one. It isn’t something that every transplant unit should try and do.

Boy is there politics! These are all the various committees and so on we’ve gone to. Of the transplants currently performed or planned to be performed in the UK, none of them has been fully funded by the NHS and they are all done a bit on the side, all with the help of charitable funding. It probably costs about twice as much as a standard transplant, but even if a transplant costs twice as much you save loads of money.

Please note, this page is a summary of the full conference speech (click here for the full transcript).

Next >>Alison Dryden - Patient Speaker

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