Single-Center Kidney Paired Donation: The Methodist San Antonio Experience
Single-Center Kidney Paired Donation: The Methodist San Antonio Experience
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DOI：
10.1111/j.1600-6143.2012.04070.x
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发表时间：
2012-08-01
影响因子：
8.8
通讯作者：
Murphey, C. L.
中科院分区：
文献类型：
--
作者：
Bingaman, A. W.;Wright, F. H., Jr.;Murphey, C. L.
由于交叉配型或血型不相容，许多潜在的肾移植接受者无法接受活体供者移植。肾配对捐赠增加了活体捐赠者移植的机会，但一直严重未得到充分利用。我们建立了肾脏配对捐献计划，包括同意的供受者配对以及与年龄较大的非人类白细胞抗原相合的捐赠者配对。在3年的时间里，共有134对供者进行了移植，其中117对血型不合，17对血型相容。所有移植均采用流式细胞术阴性交叉配型，5例采用脱敏配对供体。肾脏配对捐献移植包括双向和三向交流，以及由非定向捐赠者发起的三个链。在配对捐献的致敏受者中，44%的人计算的群体反应性抗体水平超过80%。在配对捐献的情况下，女性和先前移植受者的移植显著更高。仅发生3例排斥反应，无一例因排斥反应而丢失移植肾。这些数据突出了肾脏配对捐赠的潜力，并建议所有移植中心都应该积极参与配对捐赠，以增加活体供者移植的机会。
Many potential kidney transplant recipients are unable to receive a live donor transplant due to crossmatch or blood type incompatibility. Kidney paired donation increases access to live donor transplantation but has been significantly underutilized. We established a kidney paired donation program including consented incompatible donor/recipient pairs as well as compatible pairs with older non-human leukocyte antigen identical donors. Over a 3-year period, a total of 134 paired donor transplants were performed, including 117 incompatible pairs and 17 compatible pairs. All transplants were done with negative flow cytometry crossmatches and five were done with desensitization combined with paired donation. Kidney paired donation transplants included two-way and three-way exchanges as well as three chains initiated by nondirected donors. Of the sensitized recipients transplanted by paired donation, 44% had calculated panel reactive antibody levels greater than 80%. Transplantation of females and prior transplant recipients was significantly higher with paired donation. Only three episodes of rejection occurred and no transplants were lost due to rejection. These data highlight the potential of kidney paired donation and suggest that all transplant centers should be actively engaged in paired donation to increase access to live donor transplantation.