六名终末期肾病患者受益于印度首例非同步单中心六向肾脏交换移植手术。
Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India.
作者信息
Kute Vivek B, Patel Himanshu V, Varyani Umesh T, Shah Pankaj R, Modi Pranjal R, Shah Veena R, Rizvi Sayyed J, Pal Bipin C, Shah Priya S, Wakhare Pavan S, Ghodela Vijay A, Shinde Saiprasad G, Trivedi Varsha B, Patel Minaxi H, Trivedi Hargovind L
机构信息
Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
出版信息
World J Nephrol. 2016 Nov 6;5(6):531-537. doi: 10.5527/wjn.v5.i6.531.
AIM
To avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression.
METHODS
We present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility ( = 1); positive cross-match and/or presence of donor specific antibody ( = 5). The average time required from registration in kidney paired donation (KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo.
RESULTS
Graft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection (Banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo follow-up. The waiting time in KPD was short as compared to deceased donor KT.
CONCLUSION
We report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.
目的
为避免因成本高昂以及强化免疫抑制导致感染风险增加而采用脱敏方案和ABO血型不相容肾移植（KT）。
方法
我们展示了经机构伦理审查委员会批准的单中心6向肾交换移植研究。参与者包括ABO血型不相容者（=1例）；阳性交叉配型和/或存在供体特异性抗体者（=5例）。从登记到肾脏配对捐赠（KPD）登记处找到合适供体所需的平均时间为45天，获得法律许可后进行移植所需时间为2个月。
结果
移植肾和患者的存活率分别为100%和100%。1例患者经活检证实为急性边缘性T细胞排斥反应（2013年班夫更新版，3型）。随访9个月时平均血清肌酐为0.8mg/dL。与尸体供肾KT相比，KPD中的等待时间较短。
结论
我们报告了印度首例非同时进行的单中心6向肾交换移植。我们的经验将鼓励印度其他中心开展这种做法。
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