American Journal of Transplantation
Volume 9 Issue 10, Pages 2424 - 2428
Clinical Outcomes of Multicenter Domino Kidney Paired DonationY. J. Lee a , S. U. Lee b , S. Y. Chung c , B. H. Cho d , J. Y. Kwak e , C. M. Kang f , J. T. Park g , D. J. Han h,* and D. J. Kim a,*
a Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea b Department of Surgery, Kangdong Sacred Heart Hospital, Halym University College of Medicine, Seoul, Korea c Department of Surgery, Chonnam National University Medical School, Gwangju, Korea d Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea e Department of Surgery, Hanyang University College of Medicine, Seoul, Korea f Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea g Korean Organ and Tissue Donor Program, Seoul, Korea h Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
* Corresponding authors: Dae Joong Kim and Duck Jong Han, kimdjmed@hanmail.net, kimdjsmc@dreamwiz.com (alternate) and djhan@amc.seoul.kr
ABSTRACT
Domino kidney paired donation (KPD) is a method by which an altruistic living nondirected donor (LND) is allocated to a pool of incompatible donor–recipient pairs (DRP) and a series of KPDs is initiated. To evaluate the feasibility and clinical outcomes of multicenter domino KPD, we retrospectively analyzed a cohort of DRPs who underwent domino KPD between February 2001 and July 2007 at one of 16 transplant centers. One hundred seventy-nine kidney transplants were performed, with 70 domino chains initiated by altruistic LND. There were 45 two-pair chains, 15 three-pair chains, 7 four-pair chains, 2 five-pair chains and 1 six-pair chain. A majority of donors were spouses (47.5%) or altruistic LNDs (39.1%). DRPs with a blood type O recipient or an AB donor comprised 45.9% of transplanted DRPs. HLA mismatch improved in transplanted donors compared to intended donors in pairs enrolled to improve HLA mismatch (3.4 ± 0.7 vs. 4.8 ± 1.0, p < 0.001). One-year and 5-year graft survival rates were 98.3% and 87.7%, respectively, with a median follow-up of 46 months. One-year and 5-year patient survival rates were 97.2% and 90.8%, respectively. In conclusion, multicenter domino KPD could multiply the benefits of donation from LNDs, with patients and graft survival rates comparable to those seen with conventional KPD.
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1600-6143.2009.02747.x
http://www3.interscience.wiley.com/journal/122514768/abstract
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