Exchange Living-Donor Kidney Transplantation: Merits and Limitations

• DOI: 10.1097/tp.0b013e3181804a34
• Publication Date: 2009-03-05T22:38:47Z
• Authors: Kyu Ha Huh; Myoung Soo Kim; Man Ki Ju; Hye Kyung Chang; Hyung Joon Ahn; Su Hyung Lee; Jong Hoon Lee; Soon Il Kim; Yu Seun Kim; Kiil Park
• Keywords: Exchange transfusion; Economic shortage; Blood type (non-human)

Background. The shortage of donor organs is one the major barriers to transplantation worldwide. After success direct exchange (swap) program in Korea since 1991, we have developed a swap-around program. However, reports on long-term outcomes programs are scarce. Methods. From September 1995 2006, performed 1193 cases renal transplantation, including 398 from living-unrelated donors. donors included 129 and 269 nonexchange We compared with that program, examined merits limitations Results. reasons for were ABO incompatibility (n=84, 65.1%), human leukocyte antigen mismatching beyond our criteria (n=39, 30.2%), or positive lymphocyte crossmatch (n=6, 4.7%). overall 10-year graft survival (86.3%) was comparable (82.3%) one- haplotype matched living-related (81.2%) (P=0.2994). In multivariate analysis, versus did not affect survival. proportion blood-type O much lower group (29.5%) than (42.4%; P=0.026). Blood-type kidneys preferentially allocated recipients (78.9%) as (54.4%; P=0.007). Conclusion. achieved excellent by using an option reduce organ shortage. has no added benefit recipients.