Jessenius Faculty of Medicine
in Martin
Comenius University Bratislava

Innovative Cross-Pair Kidney Transplant Performed at University Hospital Martin

University Hospital Martin has achieved a medical milestone with its first cross-pair non-relative kidney transplant. The complex exchange involved two pairs - a married couple and siblings. Both involved departments, the Clinic of General, Visceral, and Transplant Surgery, and the Transplantation Center, are teaching bases for students at the Jessenius Faculty of Medicine, Comenius University in Martin.

29. 01. 2024 11.40 hod.

In one case, a sister wanted to donate a kidney to her sibling, and in the other, a wife was the intended donor. "However, upon examination, we found that the donors were immunologically incompatible with their recipients. Fortunately, within our transplantation center, we were able to pair these two groups in a cross-transplantation, where the immunology was much more favorable," explained Prof. Ivana Dedinská, PhD., head of the Transplantation Center at UHM.

This event marks a first in the 20-year history of the Transplantation Center at UHM. The preparatory work for the transplant took a full year, with immunologist Mgr. Andrej Čereš emphasizing the importance of monitoring antibodies that could cause the transplanted organ to fail. "In collaboration with German colleagues, we used an algorithm with artificial intelligence, enabling us to cross-exchange these two pairs. It was exceptional that both donors and recipients greatly benefited from this exchange," he elaborated.

The operation's management was also a challenge, being simultaneously conducted in two adjacent operating theaters. "We had to plan something unique to Martin, with two operating tables and teams ready – surgeons, instrument nurses, and support staff. Both surgeries had to start simultaneously to prevent any change of mind by the donors, which is a standard procedure," explained Assoc. Prof. Juraj Miklušica, PhD., head of the Clinic of General, Visceral, and Transplant Surgery at JFMED and UHM. Six surgeons were involved, with a seventh on standby.

The psychological aspect was equally demanding. "It's usual for a surgeon to operate on a sick person, but living donors are healthy individuals. We’re removing a healthy organ, which significantly increases our responsibility," Miklušica added.

This case is a beacon of hope for other kidney failure patients, highlighting the importance of contacting a transplantation center, even if a living donor is not immediately compatible. "Whenever such pairs occur, we try to combine them somehow, and this case showed that it is possible. The more pairs in the existing registry, the greater the chance of finding a potential exchange," concluded Prof. Dedinská.

Currently, 286 patients are waiting for kidney transplants in Slovakia, with 60 at the Martin Transplantation Center.