Presence of a survival benefit of HLA-incompatible living donor kidney transplantation compared to waiting or HLA-compatible deceased donor kidney transplantation with a long waiting time

Koo, Tai Yeon; Lee, Ju Han; Min, Sang Il; Lee, Yong-Gu; Kim, Myoung Soo; Ha, Jongwon; Kim, Soon Il; Ahn, Curie; Kim, Yu Seun; Kim, Jayoun; Huh, Kyu Ha; Yang, Jaeseok

doi:10.1016/j.kint.2021.01.027

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…In Korea, where the waiting time for a KTx is >5 y for sensitized patients, desensitization offers a greater survival benefit compared with matched waitlisted patients and HLA-compatible KTx. 28 Overall, these patient and kidney-graft outcomes are reassuring whatever the transplant center and the number of HLAi grafts performed. 29 However, the good results regarding the graft and patient survivals must be balanced with the higher risk of antibody-mediated rejection (AMR) and of opportunistic infections in the posttransplant period of desensitized patients.…”

Section: What Are the Results Of Desensitization For Patient-and Graf...mentioning

confidence: 99%

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Desensitization in Crossmatch-positive Kidney Transplant Candidates

Noble

Jouve

Malvezzi³

et al. 2022

Transplantation

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Access to kidney transplantation is limited by HLA-specific sensitization. Desensitization strategies enable crossmatch-positive kidney transplantation. In this review, we describe clinical experience gained over the last 20 y using desensitization strategies before kidney transplantation and describe the different tools used (both drugs and apheresis options), including IVIg, rituximab, apheresis techniques, interleukin-6 interference, proteasome inhibition, enzymatic degradation of HLA antibodies, complement inhibition, and B cytokine interference. Although access to transplantation for highly sensitized kidney transplantation candidates has been vastly improved by desensitization strategies, it remains, however, limited by the recurrence of HLA antibodies after transplantation and the occurrence of antibody-mediated rejection.

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Section: What Are the Results Of Desensitization For Patient-and Graf...mentioning

confidence: 99%

Section: What Are the Results Of Desensitization For Patient- And Gra...mentioning

confidence: 99%

Desensitization in Crossmatch-positive Kidney Transplant Candidates

Noble

Jouve

Malvezzi³

et al. 2022

Transplantation

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“…However, waiting time of sensitized recipients for deceased donor transplantation is also longer than that of wait-listed patients without sensitization 23 . Since living donor kidney transplantation after desensitization led to better patient survival than waiting for deceased donor transplantation in the United States and Korea 24 , 25 , active application of desensitization to highly sensitized recipients is expected to increase utilization of these mismatched donors. On the other hand, 14 potential donors failed to donate their kidneys due to ABO-incompatibility and high titer of anti-ABO antibodies in this study.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the donation of living kidneys for kidney transplantation

Min

Koo²,

Hwang

et al. 2022

Sci Rep

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Since the waiting time for deceased donor kidney transplantation continues to increase, living donor kidney transplantation is an important treatment for end stage kidney disease patients. Barriers to living kidney donation have been rarely investigated despite a growing interest in the utilization of living donor transplantation and the satisfaction of donor safety. Here, we retrospectively analyzed 1658 potential donors and 1273 potential recipients who visited the Seoul National University Hospital for living kidney transplantation between 2010 and 2017 to study the causes of donation discontinuation. Among 1658 potential donors, 902 (54.4%) failed to donate kidneys. The average number of potential donors that received work-up was 1.30 ± 0.66 per recipient. Among living donor kidney transplant patients, 75.1% received kidneys after work-up of the first donor and 24.9% needed work-up of two or more donors. Donor-related factors (49.2%) were the most common causes of donation discontinuation, followed by immunologic or size mismatches between donors and recipients (25.4%) and recipient-related factors (16.2%). Interestingly, withdrawal of donation consent along with refusal by recipients or family were the commonest causes, suggesting the importance of non-biomedical aspects. The elucidation of the barriers to living kidney donation could ensure more efficient and safer living kidney donation.

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“…However, waiting time of sensitized recipients for deceased donor transplantation is also longer than that of wait-listed patients without sensitization 17 . Since living donor kidney transplantation after desensitization led to better patient survival than waiting for deceased donor transplantation in the United States and Korea 18,19 , active application of desensitization to highly sensitized recipients is expected to increase utilization of these mismatched donors. On the other hand, 14 potential donors failed to donate their kidneys due to ABO-incompatibility and high titer of anti-ABO antibodies in this study.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the Donation of Living Kidneys for Kidney Transplantation

Min

Koo

Hwang

et al. 2021

Preprint

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Since the waiting time for deceased donor kidney transplantation continues to increase, living donor kidney transplantation is an important treatment for end stage kidney disease patients. Barriers to living kidney donation have been rarely investigated despite a growing interest in the utilization of living donor transplantation and the satisfaction of donor safety. Here, we retrospectively analyzed 1,658 potential donors and 1,273 potential recipients who visited the Seoul National University Hospital for living kidney transplantation between 2010 and 2017 to study the causes of donation failure. Among 1,658 potential donors, 902 (54.4%) failed to donate kidneys. The average number of potential donors that received work-up was 1.30 ± 0.66 per recipient. Among living donor kidney transplant patients, 75.1% received kidneys after work-up of the first donor and 24.9% needed work-up of two or more donors. Donor-related factors (49.2%) were the most common causes of donation failure, followed by immunologic or size mismatches between donors and recipients (25.4%) and recipient-related factors (16.2%). Interestingly, withdrawal of donation will along with refusal by recipients or family were the commonest causes, suggesting the importance of non-biomedical aspects. The elucidation of the barriers to living kidney donation could ensure more efficient and safer living kidney donation.

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Presence of a survival benefit of HLA-incompatible living donor kidney transplantation compared to waiting or HLA-compatible deceased donor kidney transplantation with a long waiting time

Cited by 10 publications

References 25 publications

Desensitization in Crossmatch-positive Kidney Transplant Candidates

Desensitization in Crossmatch-positive Kidney Transplant Candidates

Barriers to the donation of living kidneys for kidney transplantation

Barriers to the Donation of Living Kidneys for Kidney Transplantation

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