Mis-match Kidney Transplant

On November 4th 2009, Alexander Proudfoot a marketing manager and father of two from east Lothian made medical history, by becoming the first patient to receive a mis-matched kidney transplant in Scotland.

Alex received the life saving organ from his mother-in-law Ann Watt, a retired secretary from Edinburgh. He was diagnosed with polycystic kidney disease eight years before the operation. The incurable genetic condition caused his health to rapidly deteriorate until he was forced to begin kidney dialysis and join the transplant waiting list.

His wife Judy, 43, wanted to donate one of her own organs, but Alex insisted that only one of them should undergo an operation to ensure the other could look after their daughters Zoe, 16, and thirteen-year-old Katie.

Seeing the strain Alex's condition was putting on the family, Ann took the decision to step forward and offer her own kidney.

Ann said: "I desperately wanted to help because I saw how quickly Alex was going downhill. I could see how much strain the family were under. I wanted him to get a kidney, primarily for him, but also for my own daughter and my grandchildren."

Miss Lorna Marson, one of Scotland's leading transplant surgeons, had drawn together a team of cross-speciality experts, including Scottish National Blood Transfusion Service and laboratory experts, to mirror the advances being made in the United States to perform Scotland’s first ABO incompatible transplant.

The pair began a series of tests, which soon showed the pair were blood group incompatible and a transplant was impossible, but they were placed on the paired kidney register which meant they could be pooled with another matching couple anywhere else in the UK.

The new technique means that the donor and the recipient do not have to share the same blood type - something which until now has been impossible and has the potential to transform the lives of hundreds of patients and turns the current system on its head.

Normally the body's immune system would reject it immediately. However Alex underwent a month of treatment to reduce the levels of antibodies in his blood which would cause his body to attack the new organ and instead encourage it to accept.

Ms Marson said: "The concept of performing a kidney transplant between a donor and a recipient that were blood group incompatible was inconceivable. Such a transplant would have resulted in the rapid failure of the transplanted kidney."

"Until now patients like Alex would have been forced to continue on dialysis and transplant lists despite the offer of a new kidney from Ann. We hope Alex's transplant will be the first of many in Scotland."

Alex felt almost instant benefits following the procedure, while Ann was back on her feet and home within four days.

Alex said: "It is incredible. I feel well and the effects were almost instant. I used to be tired all of the time, but now I have strength and energy. I know there are lots of jokes about mother-in-laws, but we are really close and we always have been. She is an amazing woman. The transplant also means that I will be able to spend more time with my daughters and keep up with them."

Ann added: "I am just delighted I could help Alex. To hear him talking about the future with so much enthusiasm is the best reward I could have."