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Living kidney "paired donation" helps find more donors - Hopkins study.

Living kidney "paired donation" (KPD) is an effective means of finding more kidney donors by overcoming the problem of finding donors compatible with the recipient, according to a new study.

Kidney transplant surgeons at Johns Hopkins Comprehensive Transplant Center in Baltimore reported they successfully performed KPD transplants in 21 out of 22 kidney patients whose willing donors were incompatible by matching them up with other compatible pairs. The results were published in the Oct. 5 issue of The Journal of the American Medical Association (JAMA).

According to Robert Montgomery, MD, PhD, director of the transplant center and lead researcher in the study, the results could pave the way to the development of a national matching registry that would enable hundreds, perhaps thousands, of patients who cannot receive a kidney from a loved one to be transplanted by exchanging donors with a stranger.

KPD is a process in which living incompatible donor-recipient pairs are matched with other living incompatible donor-recipient pairs in order to find successful matches. For example, an incompatible donor-recipient pair with blood types A and B respectively, might be successfully matched with a donor-recipient pair who has the opposite incompatibility - blood types B and A. The A recipient would receive the A kidney, the B recipient the B kidney.

In addition to blood incompatibility, KPD is also effective with patients who have tissue incompatibilities. Tissue incompatibility can occur when a patient - who has either been pregnant or had a blood transfusion or a previous transplant - mounts an immune response against the foreign tissue. HLA antigen sensitization can cause kidney rejection and make patients incompatible with donors who share their tissue type.

Montgomery believes the time is right to develop a national network for living donors, similar to the United Network for Organ Sharing's (UNOS) system that matches deceased donor organs with compatible recipients.

"A matching system for living donors is essential since about 36% of living donor-recipient pairs will likely be blood-type incompatible, and about 30% of the patients currently on the waitlist for a kidney have HLA antigen desensitization," Montgomery said. He added that there are roughly 2,000 to 3,500 patients in the US who have living incompatible donors and about half could find a compatible match with KPD.
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Publication:Transplant News
Date:Oct 31, 2005
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