Case Report of Kidney Paired Donation (KPD) with Desensitization: the Strategy and Experience of 3-Way KPD in Samsung Medical Center
- Author:
Dongkyu OH
1
;
Eun Suk KANG
;
Shinae YU
;
Kyoungsuk CHUN
;
Wooseong HUH
;
Hye Ryoun JANG
;
Chan Woo CHO
;
Nuri LEE
;
Kyo Won LEE
;
Hyojun PARK
;
Jae Berm PARK
;
Sung Joo KIM
Author Information
- Publication Type:Case Report
- Keywords: Kidney Transplantation; Desensitization; Kidney Paired Donation; Organ Donation
- MeSH: Dialysis; Humans; Kidney Transplantation; Kidney; Living Donors; Tissue and Organ Procurement; Tissue Donors
- From:Journal of Korean Medical Science 2018;33(5):e39-
- CountryRepublic of Korea
- Language:English
- Abstract: As the need for the organ donation increases, strategies to increase kidney transplantation (KT) through expanded living donation have become essential. These include kidney paired donation (KPD) programs and desensitization in incompatible transplantations. KPD enables kidney transplant candidates with incompatible living donors to join a registry with other incompatible pairs in order to find potentially compatible living donor. Positive cross match and ABO incompatible transplantation has been successfully accomplished in selective cases with several pre-conditionings. Patients who are both difficult-to-match due to broad sensitization and hard-to-desensitize because of donor conditions can often be successfully transplanted through a combination of KPD and desensitization. According to the existing data, KPD can increase the number of KTs from living donors with excellent clinical results. This is also a cost-effective treatment as compared with dialysis and desensitization protocols. We carried out 3-way KPD transplantation with one highly sensitized, positive cross match pair and with two ABO incompatible pairs. Herein we report our first successful 3-way KPD transplantation in a single center. To maximize donor-recipient matching and minimize immunologic risk, KPD programs should use proper algorithms with desensitization to identify optimal donor with simultaneous two-, three- or more complex multi-way exchanges.
