Department of Surgery, Stanford University, CA, USA.
Am J Transplant. 2012 Sep;12(9):2429-36. doi: 10.1111/j.1600-6143.2012.04156.x. Epub 2012 Jul 19.
We report the results of a large series of chain transplantations that were facilitated by a multicenter US database in which 57 centers pooled incompatible donor/recipient pairs. Chains, initiated by nondirected donors, were identified using a computer algorithm incorporating virtual cross-matches and potential to extend chains. The first 54 chains facilitated 272 kidney transplants (mean chain length = 5.0). Seven chains ended because potential donors became unavailable to donate after their recipient received a kidney; however, every recipient whose intended donor donated was transplanted. The remaining 47 chains were eventually closed by having the last donor donate to the waiting list. Of the 272 chain recipients 46% were ethnic minorities and 63% of grafts were shipped from other centers. The number of blood type O-patients receiving a transplant (n = 90) was greater than the number of blood type O-non-directed donors (n = 32) initiating chains. We have 1-year follow up on the first 100 transplants. The mean 1-year creatinine of the first 100 transplants from this series was 1.3 mg/dL. Chain transplantation enables many recipients with immunologically incompatible donors to be transplanted with high quality grafts.
我们报告了一项大型系列链式移植的结果，该系列移植由一个美国多中心数据库促成，该数据库汇集了 57 个中心的不相容供体/受者对。通过使用一种计算机算法，结合虚拟交叉匹配和扩展链的潜力，确定了由非定向供体发起的链。前 54 个链促成了 272 例肾脏移植（平均链长= 5.0）。由于潜在的供体在接受者接受肾脏后无法捐赠，7 个链终止；但是，每个预期供体捐赠的受者都进行了移植。其余 47 个链最终通过让最后一个供体捐赠给候补名单来完成。在 272 个链接受者中，46%是少数民族，63%的移植物来自其他中心。接受移植的 O 型血患者（n = 90）数量多于发起链的 O 型非定向供体（n = 32）数量。我们对前 100 例移植的第 1 年进行了随访。来自该系列的前 100 例移植的 1 年肌酐平均值为 1.3 mg/dL。链式移植使许多免疫不相容的供体受者能够接受高质量的移植物进行移植。
