Imagine having to sit still for four hours, three times a week, week in and week out, year after year. And you know each time you start another dialysis session, your chance of going back to normal gets chipped away a little more.

These dialysis treatments are the mildest downside of living with failed kidneys.

Personally, I feel tremendously thankful for having received my kidney transplant after only a few months and without having to endure these therapy sessions. I returned to normal, but 100,000 Americans on the kidney transplant waiting list are not as fortunate.

During the last 30 years, the transplant waiting list has grown relentlessly while the number of transplants has changed very little. People wait for years, and many never get one. On average, 20 patients die every day because a donor was not found for them.

Kidneys are organs that let us eat a banana without suffering a heart attack from potassium spike. The incredibly complex network of tiny blood vessels inside kidney tissue filters many different toxins from our blood. But when these vessels fail to do their job, they can never be fixed, only replaced. Kidney transplantation is the best treatment option for kidney failure.

However, finding a donor for kidney transplantation is difficult. The biggest problem is compatibility; the donated kidney must match the patient closely enough to avoid rejection after transplantation. For example, my brother could not donate to me, because his blood type was different, and my mom had health issues that made it unsafe for her to donate. This happens often and means that a nonrelative matching donor must be found, which can be much more difficult.

Our research lab participates in the Alliance for Paired Donation program hosted at UT Medical Center, which helps patients who need a kidney transplant find a good match. This program works by finding matches with other patients and willing, but incompatible donors, and starting a donation chain. This approach, used creatively, has worked wonders to make more complicated multi-way exchanges possible. In addition, we also use deceased donors to increase compatible matches.

But finding a match and undergoing transplant surgery does not end potential problems. The human body has evolved to have protection against anything foreign. This protection system, or immunity, is helpful when it comes to dealing with infections.

Your immune system detects foreign objects by inspecting specific molecular markers on the foreign object called antigens. Human Leukocyte Antigen, or HLA, is responsible for recognition and rejection of transplanted organs. Once the immune system sees the foreign HLA, it produces antibodies — molecules that will attack and kill the transplant. But the more similar the HLA between donor and recipient, the less visible it is to the immune system and thus, the lower your chances of rejection of the new kidney.

One of our main goals is to better match donors and recipients, so that transplants will last much longer without rejection. We also are working to prevent other post-transplant complications. The ultimate goal of our research is to increase successful transplants and decrease waiting lists and kidney rejections.

How do we do this? We look at antigen matching in a new and different way.

We know that the patient’s immune system detects foreign antigens by examining both physical and chemical differences between antigens of the donor and patient. Therefore, we wanted to look at both donor and patient HLA antigens in a more complete way in our lab by carefully studying both clinical histories and blood samples from different patients.

Using this approach, we can see exactly how much antibody against donor HLA was produced by the patient’s immune system after receiving a transplant. We use this knowledge to confirm that a better match is associated with less antibodies produced by the patient’s immune system against the transplant.

Our results show that a better physical and chemical match is associated with longer survival of transplanted kidneys and patients. We are continuing to investigate this new method of donor matching to increase our knowledge and improve this method for clinical use in the future.

Overall, our initial results are promising. As our research progresses, we hope to see more transplants, fewer people die on waiting list and a reduction in rejections after transplantation.

Dulat Bekbolsynov is a PhD student in the department of medical microbiology and immunology in the Biomedical Science Program at the University of Toledo College of Medicine and Life Sciences, formerly the Medical College of Ohio. Mr. Bekbolsynov is doing his research in the laboratory of Dr. Stanislaw Stepkowski. For more information, contact Dulat.Bekbolsynov@rockets.utoledo.edu or go to utoledo.edu/​med/​grad/​biomedical.

First Published January 9, 2017, 5:00 a.m.