Materia Medica Malaysiana

UMMC service a boon to organ transplants

KUALA LUMPUR: The University Malaya Medical Centre (UMMC) has developed and made available a service that will help improve Malaysia’s transplant programme involving major organs like kidney, heart and liver by identifying potential recipients according to risk.

The service involves measuring a potential recipient’s reaction to a type of protein, known as anti-human leucocyte antigents (anti-HLA), which is unique and different for each individual, much like a person’s fingerprint.

A computer can read the reaction between the potential recipient’s antibodies and the proteins.

Prof Dr S.Y. Tan, consultant nephrologist and transplant physician of UMMC’s Renal Unit said the measurement of these anti-HLA antibodies, also known as Panel Reactive Antibodies (PRA), is important as it helped to identify patients who have greater risk of rejection before and following a transplant.

“The most important and well-proven use of the PRA test is its ability to identify high risk patients who would then be given a higher ranking on the waiting list as the chances of finding a suitable matching donor is reduced compared to low risk patients,” he said.


Prof Tan
“There is also evidence that monitoring a patient’s PRA after transplantation could help identify patients who may subsequently develop rejection even when they have been classified as low risk prior to transplantation.

“It, therefore, is able to predict to some extent whether the patient will do well or not after a transplant because the main complication is organ rejection,” says Tan, who heads UMMC’s Renal Unit.

He said a major challenge for transplant physicians is the choice of drugs to be used to reduce rejection.

“Drugs which provide maximum protection against rejection, are, generally more powerful, more expensive, and may have more side effects. The use of such drugs, however, may be necessary and justifiable.