Department of Nephrology, Fremantle Hospital, Perth, WA, Australia.
Transpl Int. 2012 Oct;25(10):1026-31. doi: 10.1111/j.1432-2277.2012.01541.x. Epub 2012 Aug 14.
In the Australian kidney paired donation (KPD) program matching is based on acceptable mismatches, whereas deceased donor waitlist (DDWL) patients are allocated kidneys based on HLA antigen matching rules. Herein, we compared waiting time for a KPD match to the waiting time on the DDWL and the occurrence of matching in the DDWL for patients who were registered in both programs. Data on first dialysis, matches on the DDWL, KPD program entry, matches and transplant dates were assessed in 26 KPD recipients of the Australian program. There were 22 recipients who were listed in the DDWL and received kidney transplants by KPD. Time on dialysis until KPD transplantation was 808 ± 646 days. Eleven patients had never been matched with a deceased donor (waiting time 345 ± 237 days) and 11 had been matched on average 3 ± 5 times (waiting time 1227 ± 615 days, P < 0.0001 vs. never matched), but did not progress to transplantation because of positive crossmatch or class II donor-specific antibody. Mean time from registration in the KPD program until kidney transplantation was 153 ± 92 days (P < 0.0001 vs. DDWL). KPD allocation using the acceptable mismatch approach is effective in identifying suitable live donors for some recipients within a relatively short time-frame.
在澳大利亚的肾脏配对捐赠（KPD）计划中，匹配是基于可接受的不匹配，而已故供体等待名单（DDWL）患者则根据 HLA 抗原匹配规则分配肾脏。在此，我们比较了 KPD 匹配的等待时间与 DDWL 的等待时间，以及在两个计划中登记的患者在 DDWL 中的匹配情况。评估了澳大利亚计划中 26 名 KPD 受者的首次透析、DDWL 上的匹配、KPD 计划入组、匹配和移植日期的数据。有 22 名受者在 DDWL 上登记，并通过 KPD 接受了肾脏移植。从透析到 KPD 移植的时间为 808 ± 646 天。11 名患者从未与已故供体匹配（等待时间 345 ± 237 天），11 名患者平均匹配 3 ± 5 次（等待时间 1227 ± 615 天，P < 0.0001 与从未匹配），但由于交叉匹配或 II 类供体特异性抗体阳性而未进展为移植。从 KPD 计划登记到肾脏移植的平均时间为 153 ± 92 天（P < 0.0001 与 DDWL）。使用可接受的不匹配方法进行 KPD 分配，可在相对较短的时间内有效确定一些受者的合适活体供者。
