Mahendran A O, Veitch P S
Renal Transplantation Unit, Royal Free Hospital and University College London Medical School, Pond Street, London NW3 2QG, UK.
Br J Surg. 2007 Jun;94(6):657-64. doi: 10.1002/bjs.5818.
Kidney paired donation (KPD) is an exchange of organs between two live donors, who are otherwise ABO incompatible or cross-match positive, and their intended recipients. The outcome is the generation of compatible transplants conferring an improvement in quality of life and longevity.
Medline was searched for articles on KPD using a combination of keywords. Publications focusing on protocols and policy, mathematical modelling, ethical controversies, and legal and logistical barriers were identified.
Many are precluded from transplantation because of incompatibilities with their intended donors. KPD has the potential to increase the rate of transplantation by facilitating exchange transplants between otherwise incompatible donor-recipient couples. Ethical controversies surrounding paired donation include confidentiality, conditionality of donation, synchronicity of operations and the possibility of disadvantaging blood group O recipients. Logistical barriers hampering KPD programmes involve the location of donor surgery and organ transport.
Paired donation may expand the living donor pool by providing an alternative successful strategy for incompatible donor-recipient couples. Its widespread implementation will depend on resolving ethical and logistical constraints.
肾脏配对捐赠（KPD）是两名活体捐赠者之间的器官交换，这两名捐赠者在其他方面存在ABO血型不相容或交叉配型阳性的情况，以及他们各自的预期受者之间的器官交换。其结果是产生相容性移植，从而改善生活质量并延长寿命。
使用关键词组合在Medline数据库中检索关于KPD的文章。确定了关注方案与政策、数学建模、伦理争议以及法律和后勤障碍的出版物。
许多人因与其预期捐赠者不相容而被排除在移植之外。KPD有潜力通过促进原本不相容的供受者夫妇之间的交换移植来提高移植率。围绕配对捐赠的伦理争议包括保密性、捐赠的条件性、手术的同步性以及使O型血受者处于不利地位的可能性。阻碍KPD项目的后勤障碍涉及供体手术的地点和器官运输。
配对捐赠可能通过为不相容的供受者夫妇提供另一种成功策略来扩大活体捐赠者库。其广泛实施将取决于解决伦理和后勤方面的限制。
