Fusion_Plantation

Transfusion and Transplantation are chapters of medical practice with evidence based status since several decennies. Their application in helping improvement of patient survival and life quality has spurred widespread usage around the globe. As an example, the Asan Medical Center, in Seoul, Korea, has so far transplanted approximately 1100 livers, 1600 kidneys 800 hearts and   has performed 770 bone marrow transplantations. In small Switzerland with its approx. 7 mio inhabitants, 699 hearts have been transplanted between 1986 and 2003. We will update this page during july 2005 in order to get more numbers worldwide. The most prominent immunological hurdles between donor and recipient are the ABO histo-blood group system and the HLA system (see adjacent figure), whereby many so called blood groups are now identified as histo-blood groups. Kidd and Duffy disparities between donor and recipient might influence the rejection rate in kidney transplantation. Transplantation levels off since many years because of the paucity of organ donors (www.unos.org). Such levelling is due, in part, because the ABO barrier prevents donor/recipient pairing with say A into O donation. Adaptive loss of the malarial parasite receptor protein Duffy on red blood cells is known to occur in West Africans living in areas where malaria is endemic; nearly 100% of humans in this region selectively lack Duffy proteins on these cells whereas they remain expressed on brain, spleen and kidney cells (see: Scientific American 2008, may issue, page 44).

The figure is from Annals of N Y Academy of Sciences, volume 1050, june 2005:40-51

The figure takes a new impact with

Lerut E et al: Duffy and Kidd blood group antigens: minor histocompatibility antigens involved in renal allograft rejection? Transfusion 2007;47:28