Johnson Rachel J, Allen Joanne E, Fuggle Susan V, Bradley J Andrew, Rudge Chris
UK Transplant, NHS Blood and Transplant, Bristol, United Kingdom.
Transplantation. 2008 Dec 27;86(12):1672-7. doi: 10.1097/TP.0b013e3181901a3d.
Paired living kidney donation became possible in the United Kingdom in 2006 after the introduction of a new legal framework for organ donation. A national matching scheme was subsequently established and we report the early United Kingdom experience of paired donation.
A new national matching algorithm was developed for the introduction of paired donation in the United Kingdom. Initially, all potential two-way exchanges were identified with prioritization according to a points system based on geographical proximity between pairs, calculated human leukocyte antigen antibody reaction frequency (cRF), HLA mismatch of potential transplant, and donor-donor age difference. Three-way exchanges were additionally considered after the first year.
The list for paired donation has grown steadily as 3-monthly "matching runs" have been carried out from April 2007, and in July 2008 there were 85 couples registered. Eight paired donor transplants have resulted with a number of identified exchanges unable to proceed. Fewer potential exchanges have been identified than expected due to blood group composition (47 of 85 donors of group A compared with 16 potential recipients [A, AB]) and high levels of cRF (95%-100% in 35% of patients) among listed patients.
Paired donation has been introduced successfully in the United Kingdom, adding to living donor transplant activity. The new national program has yielded fewer transplants than initially anticipated but as the scheme evolves, with the use of altruistic, nondirected donors to start a "chain" of transplants, an increase in the number of successful paired donation transplants is anticipated.
2006年英国引入新的器官捐赠法律框架后，配对活体肾捐赠成为可能。随后建立了全国性的匹配计划，我们报告了英国配对捐赠的早期经验。
为在英国引入配对捐赠开发了一种新的全国匹配算法。最初，根据基于配对双方地理距离、计算得出的人类白细胞抗原抗体反应频率（cRF）、潜在移植的HLA错配以及供体-供体年龄差异的积分系统确定所有潜在的双向交换，并进行优先级排序。第一年之后还考虑了三方交换。
自2007年4月开始每3个月进行一次“匹配运行”以来，配对捐赠名单稳步增加，2008年7月有85对夫妇登记。已经完成了8例配对供体移植，还有一些已确定的交换无法进行。由于血型构成（85名A型供体中有47名，而潜在受者为16名[A、AB型]）以及登记患者中cRF水平较高（35%的患者中为95%-100%），确定的潜在交换比预期的要少。
配对捐赠已在英国成功引入，增加了活体供体移植活动。新的全国性计划产生的移植数量比最初预期的要少，但随着该计划的发展，利用利他、非定向供体启动移植“链”，预计成功的配对捐赠移植数量将会增加。
