An important factor in a successful transplant is tricking the body into believing that the donor organ is a friend and shouldn ’ t be rejected . To help match the donor and recipient and reduce the risk of rejection , the UAB CTI performs HLA antibody testing prior to transplantation .
LIVER
ORGANS – LIVER for a transplant . After 10 terrifying bleeding episodes similar to the one following her tick bite , Derryberry was advised by her kidney doctor to contact the UAB Comprehensive Transplant Institute ( CTI ).
“ Thank God I did – I found my people ,” Derryberry said . “ They listened , they didn ’ t balk at me saying that I wanted both a liver and a kidney , and they talked to me about the course of action they would take .” Coming from a blue-collar family and being a rodeo mom of four , it didn ’ t hurt that , at her first appointment , UAB CTI surgeon Robert Cannon , M . D ., walked in wearing scrubs and cowboy boots .
Derryberry ’ s care team was very proactive in optimizing her health during her nearly three years on the waitlist . “ They implemented a different regimen and approach to care even before the transplant ,” Derryberry said . “ We had conversations that changed everything for me .” A year before her transplant , Derryberry underwent a procedure designed to stop the bleeds by relieving the pressure in her liver . “ I didn ’ t have another bleed after that procedure ,” she said .
An important factor in a successful transplant is tricking the body into believing that the donor organ is a friend and shouldn ’ t be rejected . To help match the donor and recipient and reduce the risk of rejection , the UAB CTI performs HLA antibody testing prior to transplantation .
However , Houp was up for the challenge : “ I know a few tricks ,” she said . The best-case scenario in transplantation is to avoid all antibodies . “ She had so many antibodies that we didn ’ t have that luxury ,” Houp said of Derryberry , “ so it became a question of whether we could tell which ones were the worst from all the antibodies she had .”
The risk of rejection To recognize friend from foe , the body ’ s immune system relies on human leukocyte antigens ( HLA ). An important factor in a successful transplant is tricking the body into believing that the donor organ is a friend and shouldn ’ t be rejected . To help match the donor and recipient and reduce the risk of rejection , the UAB CTI performs HLA antibody testing prior to transplantation . This testing is carried out by the CTI ’ s state-of-the-art Histocompatibility and Immunogenetics Lab .
The challenge in finding a donor match for Derryberry was the variety of antibodies in her system . “ Every time she got a blood transfusion , she received a different HLA ,” said Julie Houp , associate director of the Histocompatibility and Immunogenetics Lab . Every HLA created a new antibody , and every antibody increased her risk of rejection . “ It was like a runaway train ,” Houp added .
Derryberry put it more bluntly : “ My chance of a match was 2 %,” she said . “ I was a unicorn .”
Identifying and avoiding the worst antibodies paved the way for Derryberry ’ s transplants – in the right order . “ If the liver is transplanted first , it can absorb some of the antibodies without causing damage ,” Houp said . “ Once it soaks up the antibodies , it ’ s then possible to safely transplant the kidney .”
Finding a match However , Houp still needed to find a donor match . A regular blood serum analysis couldn ’ t reveal the good antibodies from the bad , so Derryberry ’ s blood serum was diluted . “ That allowed us to see which antibodies remained potent ,” Houp said . “ We were able to predict which antibodies we should avoid and which we should try to crossmatch .”
When Derryberry received her liver transplant on July 31 , 2022 , her new liver responded as Houp predicted . “ Six to eight hours after , we saw a reduction in antibodies ,” she said . “ They were out of circulation and couldn ’ t damage the kidney .” The UAB CTI surgeons then transplanted Derryberry ’ s new kidney .
20 UAB CTI Report