Weng Francis L, Grogan Tracy, Patel Anup M, Mulgaonkar Shamkant, Morgievich Marie M
Renal & Pancreas Transplant Division, Saint Barnabas Medical Center, Livingston, NJ, USA.
Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
Clin Transplant. 2017 Jun;31(6). doi: 10.1111/ctr.12978. Epub 2017 Apr 24.
Compatible pairs of living kidney donors and their intended recipients can enter into kidney paired donation (KPD) and facilitate additional living donor kidney transplants (LDKTs). We examined 11 compatible pairs (the intended recipients and their intended, compatible donors) who participated in KPD, along with the recipients' 11 matched, exchange donors. The 11 pairs participated in 10 separate exchanges (three were multicenter exchanges) that included 33 total LDKTs (22 additional LDKTs). All the intended donors were blood group O and female, with a mean living kidney donor profile index (LKDPI) of 27.6 (SD 16.8). The matched donors had a mean LKDPI of 9.4 (SD 31.7). Compatible pairs entered KPD for altruistic reasons (N=2) or due to mismatch of age (N=7) or body/kidney size (N=2) between the recipient and intended donor. In four cases, retrospective calculation of the LKDPI revealed that the matched donor had a higher LKDPI than the intended donor. Of the 22 recipients of LDKTs enabled by the compatible pairs, three were highly sensitized, with PRA >80%. In conclusion, most compatible pairs entered into KPD so that the recipient could receive a LDKT transplant from a donor whose age or body/kidney size were more favorable to post-transplant outcomes.
相匹配的活体肾供体及其预定受者可以参与肾交换捐赠(KPD),并促成更多的活体供肾移植(LDKT)。我们研究了11对参与KPD的相匹配的供受者对(预定受者及其预定的相匹配供体),以及受者的11名匹配的交换供体。这11对参与了10次单独的交换(3次是多中心交换),总共包括33例LDKT(22例额外的LDKT)。所有预定供体均为O型血且为女性,平均活体肾供体特征指数(LKDPI)为27.6(标准差16.8)。匹配的供体平均LKDPI为9.4(标准差31.7)。相匹配的供受者对参与KPD的原因是出于利他主义(N = 2),或者是由于受者与预定供体之间年龄不匹配(N = 7)或身体/肾脏大小不匹配(N = 2)。在4例中,对LKDPI的回顾性计算显示,匹配的供体的LKDPI高于预定供体。在由相匹配的供受者对促成的22例LDKT受者中,3例高度致敏,群体反应性抗体(PRA)>80%。总之,大多数相匹配的供受者对参与KPD是为了使受者能够从年龄或身体/肾脏大小对移植后结果更有利的供体那里接受LDKT移植。