ABO血型不相容活體腎臟移植-中國醫藥大學附設醫院經驗
蕭博任1、陳冠亨1、黃志平1、葉進仲1、黃秋錦2、張兆祥1
中國醫藥大學附設醫院 泌尿部1、腎臟科2
ABO-incompatible living related donor renal transplantations: experience from China Medical University Hospital
Po-Jen Hsiao1, Guang-Heng Chen1, Chi-Ping Huang1, Chin-Chung Yeh1, Chiu-Ching Huang2, Chao-Hsiang Chang1
Department of Urology1, China Medical University Hospital, Taichung, Taiwan; Department of Nephrology2, China Medical University Hospital, Taichung, Taiwan
Purpose: With the increasing number of patients on the waiting list for renal transplants in Taiwan, crossing the blood group barrier can substantially increase the donor pool. We started ABO-incompatible living related renal transplantation since 2007 with some different protocol. This study reports the outcome of ABO-incompatible living related renal transplantations performed at our institution.
Materials and Methods: A total of 28 adult ABO-incompatible living kidney transplant recipients were included in the study. All of them underwent a pretransplantation conditioning program for desensitization, which included Tarcolimus, mycophenolate mofetil and Basiliximab. Plasmapheresis and rituximab was added in some situations.
Results: There are 12 blood group O donors to A recipients, 5 blood group O donors to B recipients, 3 blood group B donors to AB recipients, 3 blood group B donors to O recipients, 3 blood group A donors to O recipients, 1 blood group B donors to A recipients, and 1 blood group AB donors to A recipients. All the patients achieved immediate graft function post-transplantation. Two graft was lost. One of the failure graft due to severe antibody-mediated rejection (ABMR) with cortical necrosis. The other graft is lost because of severe infection and the recipient even expired. The graft survival rate was 92.86% and the patient survival rate was 96.42%.
Conclusions: ABO-incompatible living related renal transplantation is a good choice to increase the donor pool. We demonstrate favorable allograft outcome in living donor kidney transplant recipients after desensitization.