Pioneering Kidney Surgery Chelsea Bury, 14, has paved the way for children seriously ill with kidney disease to receive transplants from donors who don't match their blood type. The waiting list for children in need of a new kidney could be cut by a third. Chelsea, who played six types of sport before she became ill, was the first child in Australia to receive such a transplant, just over a week ago. It's early days, but Chelsea's kidney - donated by her father, Nigel, 49 - seems to be working perfectly, and the Sydney schoolgirl was out of hospital and home in just nine days. In order to be able to accept her father's kidney, Chelsea had to undergo a series of therapies known as plasmapheresis, which is similar to dialysis, where the blood is cleared, not of toxins, but of the plasma which carries antibodies that cause organ rejection in transplants. Chelsea then received donor plasma that was anti-body free. Chelsea was also put on a more complex regime of immunosuppressive medications, and suffered through extensive testing. She's had two further sessions of plasmapheresis sessions since surgery. Some transplant patients who have undergone plasmapheresis have also required the removal of their spleen, which produces antibodies. Fiona Mackie, the head of nephrology at Sydney Children's Hospital, said up to a third of children in need of a transplant, had blood that was incompatible with their parents, meaning in the past they could not receive an organ from them. "In general, most parents want to donate to their children, and being blood-type incompatible is the most common reason that they can't," she said. We can't know for sure how many more parents will be able to donate, but it could potentially be up to a third. Dr Mackie said the procedure had been "really intense" for the medical and nursing staff, as well as for Chelsea. But she was already "looking great." It's been a tough year for Chelsea. She was born with kidney disease, though doctors had thought her kidneys would last into her 30s. But illness triggered a sudden and terrifying kidney failure late last year. So began a seemingly endless series of tests, hospitalisation, and, eventually, dialysis to artificially filter her blood. "I've only gone to about 30 to 40 days of school this year," Chelsea says. Dr Mackie had initially told Chelsea she'd be on dialysis for a year to 18 months, until a kidney became available through the deceased donor system. "It's a very difficult life being on dialysis," said Fiona Mackie. It necessitates coming to the hospital three times a week for five or six hours at a time and it's difficult to incorporate that into being a child. When Chelsea had an especially difficult time on dialysis, and began suffering multiple infections, Dr Mackie considered other options. Plasmapheresis as a means of obtaining an organ from an incompatible donor was pioneered in Japan and the US, and has been performed successfully in Australia since 2006, with adult recipients. It had not been attempted with a child patient. "I think Chelsea has been very, very brave," said Jo Bury, Chelsea's mother. It's been hard for her, she has had to miss out on a lot. But she seems to bounce back and cope with it all. Equally brave was Chelsea's father, Nigel - he'd never had surgery before. "She's a bit of a chip off the old block, Chelsea is," he says. We're thick as thieves. As he went into surgery, red-eyed from little sleep the night before, he ruminated: "Accidents can happen, there could be a stuff-up." When father and daughter were reunited, Chelsea was overwhelmed, bursting into tears, prompting Nigel to climb out of his wheelchair and hold her tight. "It's OK," he said. "It hurts," she said. Later, Chelsea wasn't sure why she cried. They were happy tears. Mother Jo thinks the family was so focused on the transplant that they didn't really think much about the aftermath. The days following the surgery have been up and down. "Apparently for a kidney transplant, even if they are compatible for the first two weeks, it's quite tricky," said Jo, a week later. One moment everything is great, but then there are sleepless nights and pain. Ten days on, Chelsea says she's pain free. They say, 'do you want a Panadol?' and I say 'nup'. Meanwhile, the surgery team considers the procedure so successful, they are already preparing to perform another plasmapheresis-based transplant on another child. The executive officer of the ANZDATA kidney registry, Stephen McDonald, said there were between 230 and 250 living kidney donations each year, with between 30 and 40 of those using non blood-matched donors. Living organ donation rates in Australia have fallen, down from 42 per cent of all kidney donations in Australia in 2009 to 31 per cent in 2011. The children's waiting list has increased.