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
- Authors
- Koo, Tai Yeon; Lee, Ju Han; Min, Sang-Il; Lee, Yonggu; Kim, Myung Soo; Ha, Jongwon; Kim, Soon Il; Ahn, Curie; Kim, Yu Seun; Kim, Jayoun; Huh, Kyu Ha; Yang, Jaeseok
- Issue Date
- Jul-2021
- Publisher
- Elsevier B.V.
- Keywords
- desensitization; donor-specific antibody; HLA incompatible; kidney transplantation; waiting time
- Citation
- Kidney International, v.100, no.1, pp 206 - 214
- Pages
- 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Kidney International
- Volume
- 100
- Number
- 1
- Start Page
- 206
- End Page
- 214
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/986
- DOI
- 10.1016/j.kint.2021.01.027
- ISSN
- 0085-2538
1523-1755
- Abstract
- HLA-incompatible living donor kidney transplantation (LDKT) is one of efforts to increase kidney transplantation opportunity for sensitized patients with kidney failure. However, there are conflicting reports for outcomes of HLA-incompatible kidney transplantation compared to patients who wait for HLA-compatible deceased donor kidney transplantation (DDKT) in the United States and United Kingdom. Waiting for an HLA-compatible DDKT is relatively disadvantageous in Korea, because the average waiting time is more than five years. To study this further, we compared outcomes of HLA-incompatible LDKT with those who wait for HLA-compatible DDKT in Korea. One hundred eighty nine patients underwent HLA-incompatible LDKT after desensitization between 2006 and 2018 in two Korean hospitals (42 with a positive complement-dependent cytotoxicity cross-match, 89 with a positive flow cytometric cross-match, and 58 with a positive donor-specific antibody with negative cross-match). The distribution of matched variables was comparable between the HLA-incompatible LDKT group and the matched control groups (waiting-list-only group; and the waiting-list-or-HLA-compatible-DDKT groups; 930 patients each). The HLA-incompatible LDKT group showed a significantly better patient survival rate compared to the waiting-list-only group and the waiting-list-or-HLA-compatible-DDKT groups. Furthermore, the HLA-incompatible LDKT group showed a significant survival benefit as compared with the matched groups at all strength of donor-specific antibodies. Thus, HLA-incompatible LDKT could have a survival benefit as compared with patients who were waitlisted for HLA-compatible DDKT or received HLA-compatible DDKT in Korea. This suggests that HLA-incompatible LDKT as a good option for sensitized patients with kidney failure in countries with prolonged waiting times for DDKT.
- Files in This Item
-
Go to Link
- Appears in
Collections - 서울 의과대학 > 서울 내과학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/986)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.