Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, Gujarat , India .
Ren Fail. 2014 Apr;36(3):447-50. doi: 10.3109/0886022X.2013.868294. Epub 2013 Dec 17.
Despite heightened international interest in performing living donor kidney paired donation (KPD) transplantation after the publication of a research protocol by Ross and colleagues in 1997, only a few hundred have been performed worldwide. The major obstacle is that many individuals in end-stage renal disease are of blood type O and can only receive an organ from a donor of blood type O, whereas blood type O donors are "universal donors" and will be able to donate directly with an intended recipient of any blood type unless there is a positive crossmatch. To overcome this, patients with compatible but non-HLA identical donors over 45 years of age should be approached for inclusion in KPD program especially O blood group donors. Inclusion of all these additional pairs into the algorithm greatly increases chances of possible matches for O blood group recipients. We report successful three-way KPD transplantation resulting in transplantation of O blood group patient using compatible O blood group donor from India. None of the patients had delayed graft function or rejection and all had stable graft function on discharge without any medical and surgical complications. We need to allocate O blood group kidneys from compatible donors to overcome the barrier of HLA, non-HLA antibodies and other donor related factors to improve transplant quality and long term outcomes. This will increase transplantation of O blood group patients.
尽管 1997 年 Ross 及其同事发表了一项研究方案后，国际上对开展活体供肾配对捐赠（KPD）移植的兴趣有所增加，但全世界仅进行了数百例。主要障碍是许多终末期肾病患者的血型为 O 型，只能接受 O 型供体的器官，而 O 型血供体是“万能供体”，可以直接与任何血型的预期受者进行捐赠，除非存在阳性交叉配型。为克服这一障碍，应考虑将年龄超过 45 岁、有相容但非 HLA 相同供体的患者纳入 KPD 计划，特别是 O 型血供体。将所有这些额外的配对纳入算法中，大大增加了 O 型血受者可能匹配的机会。我们报告了成功的三方 KPD 移植，使用来自印度的相容 O 型血供体移植了 O 型血患者。所有患者均无移植肾功能延迟恢复或排斥反应，出院时所有患者的移植物功能均稳定，无任何医疗和手术并发症。我们需要从相容供体分配 O 型血肾脏，以克服 HLA、非 HLA 抗体和其他与供体相关的因素的障碍，从而提高移植质量和长期结果。这将增加 O 型血患者的移植数量。
