Increased access to transplantation for blood group B cadaveric waiting list candidates by using A2 kidneys:: Time for a new national system?
Increased access to transplantation for blood group B cadaveric waiting list candidates by using A2 kidneys:: Time for a new national system?
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DOI：
10.1034/j.1600-6143.2002.020115.x
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发表时间：
2002-01-01
影响因子：
8.8
通讯作者：
Bryan, CF
中科院分区：
文献类型：
--
作者：
Nelson, PW;Shield, CF;Bryan, CF
由于B血型终末期肾病（ESRD）患者获得供体肾脏的机会较少，少数族裔比例高于任何其他血型，器官共享联合网络（UNOS）批准了一项自愿国家肾脏分配差异，允许器官采购组织（OPO）优先将A（2）和A（2）B肾脏分配给B候选人。中西部移植网络OPO优先分配和移植来自血型A（2）和A（2）B供体的肾脏给我们的血型B等待名单候选人超过7年，以增加我们OPO范围等待名单上的B候选人获得肾脏的机会。在1994年至2000年期间，共有121例B血型终末期肾病患者从我们的OPO范围的尸体肾等待名单进行移植。34%（41/121）的B候选人接受了A（2）或A（2）B肾。A（2）或A（2）B肾的B受体组的1年和5年移植物存活率分别为91%和85%（移植物功能正常时死亡[DWFG]删失），与80例B或O肾的B受体组的91%和80%无显著差异（Wilcoxon = 0.48;对数秩= 0.55）。这些数据支持额外OPO自愿优先将A（2）和A（2）B肾分配给B等待名单候选人的国家试验，从而增加B血型患者接受肾移植的机会。
Since blood group B end-stage renal disease (ESRD) patients have less access to donor kidneys and a higher minority composition than any other blood group, the United Network for Organ Sharing (UNOS) approved a voluntary national kidney allocation variance to allow organ procurement organizations (OPOs) to preferentially allocate A(2) and A(2)B kidneys to B candidates. The Midwest Transplant Network OPO has preferentially allocated and transplanted kidneys from blood group A(2) and A(2)B donors to our blood group B waiting list candidates for more than 7 years to increase access to kidneys for the B candidates on our OPO-wide waiting list. Between 1994 and 2000, a total of 121 blood group B ESRD patients from our OPO-wide cadaveric kidney waiting list were transplanted. Thirty-four per cent (41/121) of those B candidates received either an A(2) or an A(2)B kidney. One- and 5-year graft survival rates for the group of B recipients of A(2) or A(2)B kidneys were 91 and 85% (died with functioning graft [DWFG] censored), respectively, which were not significantly different from those of 91 and 80% for the 80 B recipients of B or O kidneys (Wilcoxon = 0.48; log-rank = 0.55). These data support the national trial for additional OPOs to voluntarily allocate A(2) and A(2)B kidneys preferentially to B waiting list candidates, thus increasing access of blood group B patients to renal transplantation.