Gruessner Rainer W G, Gruessner Angelika C
SUNY Downstate Health Sciences University, New York City, New York, USA.
Clin Transplant. 2023 Apr;37(4):e14923. doi: 10.1111/ctr.14923. Epub 2023 Feb 5.
Dual organ donation and transplantation from living donors (LDs) is a rare practice. Dual organ transplants can be done from the same LD or from different LDs and either simultaneously or sequentially. Simultaneous dual organ transplants from the same LD are of considerable concern due to the magnitude of the donor procedure.
According to the UNOS/OPTN and IPTR databases, the US experience of LD dual organ transplants from 1981 to 2021 comprised 101 simultaneous or sequential dual organ transplants from the same LD and 111 transplants from different LDs for a total of 212 LD dual transplants. The first simultaneous or sequential dual organ transplants from either the same LD or different LDs were pancreas-kidney transplants (n = 92). Four additional LD organ transplant combinations have been performed in the United States: liver-kidney (n = 93), lung-kidney (n = 16), liver-intestine (n = 9), and intestine-kidney (n = 2). Only for dual pancreas-kidney (n = 49) and liver-intestinal transplants (n = 4), organs from the same LD have been procured simultaneously. Importantly, no donor deaths have been reported after any simultaneous or sequential procurement. LD dual organ outcomes in all recipient categories have been excellent.
LD dual organ donation and transplantation is safe and successful. Any potential dual organ LD candidate must be subject to the highest level of evaluation scrutiny. A (dual) organ donor registry is warranted for long-term follow-up.
活体供体的双器官捐赠和移植是一种罕见的做法。双器官移植可以来自同一个活体供体,也可以来自不同的活体供体,可以同时进行,也可以先后进行。由于供体手术的规模,来自同一个活体供体的同时双器官移植备受关注。
根据美国器官共享联合网络(UNOS)/器官获取与移植网络(OPTN)和国际胰腺移植登记处(IPTR)数据库,1981年至2021年美国活体供体双器官移植的经验包括101例来自同一个活体供体的同时或先后双器官移植以及111例来自不同活体供体的移植,总共212例活体供体双器官移植。首例来自同一个或不同活体供体的同时或先后双器官移植是胰肾移植(n = 92)。在美国还进行了另外四种活体供体器官移植组合:肝肾移植(n = 93)、肺肾移植(n = 16)、肝肠移植(n = 9)和肠肾移植(n = 2)。仅对于双胰肾移植(n = 49)和肝肠移植(n = 4),来自同一个活体供体的器官是同时获取的。重要的是,在任何同时或先后获取后均未报告供体死亡。所有受者类别的活体供体双器官移植结果都非常好。
活体供体双器官捐赠和移植是安全且成功的。任何潜在的双器官活体供体候选者都必须接受最高水平的评估审查。有必要建立一个(双)器官供体登记处进行长期随访。