The Outcome of Renal Transplantation Using Exchange Donor Program.
- Author:
En Jung SHIN
1
;
Oh Jung KWON
Author Information
1. Department of Surgery, Collge of Medicine, Hanyang University, Seoul, Korea. ojkwon@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Exchange donor;
Graft survival rate;
Donor pool
- MeSH:
Follow-Up Studies;
Graft Survival;
Humans;
Kidney;
Kidney Transplantation*;
Living Donors;
Retrospective Studies;
Survival Rate;
Tissue Donors*;
Volunteers
- From:The Journal of the Korean Society for Transplantation
2007;21(1):123-127
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The availability of living donors is the major limiting factor in living related kidney transplantion. In 1997, Ross et al. proposed that the living unrelated kidney transplantation through exchange arrangement of ABO-incompatible donors-recipient pairs to expand donor pool is ethically acceptable as living related kidney transplantation. We analyzed exchange donor program whether this could expand the kidney donor pool in living donor renal transplantation. METHODS: We retrospectively reviewed the records of the 121 exchange donor renal transplantations performed from 1991 to 2005 in our center. Recipient's and donor's mean age were 38.8 (15~64) and 40.4 (21~60) year-old, respectively. Mean follow up period is 81 months (1~170). The reasons of exchanging donor were ABO incompatibility (92/121, 76%), positive HLA cross matching (20/121, 16%) and patients who received kidneys from unknown volunteer donors (9/121, 7%). We compared graft survival and acute rejection rate of exchange donor group and living related donor group. RESULTS: The graft survival rate (1, 5, 10 year) of exchange donor group (92%, 80.6%, 72%) was similar to living related donor groups (95%, 77%, 66%). The acute rejection rate were 34% (42/121 ) and 24%, respectively. We have observed acute rejections during the same time in both groups from 1991 to 2005. Although acute rejection rate of exchange donor group is higher, we see the similar survival rate of transplanted kidneys in exchange donor group. CONCLUSION: We suggest that exchange donor program could expand the donor pool in living donor renal transplantation, when recipient cannot receive kidney from healthy donor because of ABO incompatibility or positive HLA cross matching.
