Abstract:

OBJECTIVE: Some studies have documented that living donor kidney transplantation has a better clinical results than cadaveric donors, however, it is poorly understood whether different living-related donors has different effects on kidney transplantation. The aim of this study is to discuss the clinical results of different living-related donors on kidney transplantation, in addition, to analyze the related problems including the donor selection, and relation of type matching with transplantation results.
METHODS: Donors comprise 36 males and 58 females, aged (42.6±8.8) years. There were 72 males and 22 females received kidney transplantation, aged (33.9±8.7) years. Except for 6 cases being donated by spouse, 35 cases were donated by parents and 53 cases were donated by brothers and sisters. As to human leucocyte antigen (HLA) matching, 18 cases were full matched, 2 cases shared one-haplotype mismatched, 5 cases with 2-haplotype mismatched, 2 cases with 3-haplotype mismatched, 2 cases with 4-haplotype mismatched, and 1 case with 5-haplotype mismatched, 10 cases with full mismatched. Totally 85 cases had identical blood type, 9 cases had blood type compatibility. All recipients were negative for panel reaction antibody with smaller than 10% of lymphocytotoxicity tests prior to transplantation.
RESULTS: All donors recovered well. Acute rejection episodes occurred in 8 patients, 4 cases donated by parents, 3 cases donated by siblings and 1 case donated by spouse. One recipient donated by spouse suffered accelerated rejection and delayed graft function recovery occurred. The renal function recovered in 5 weeks post-operation. All cases were reversed successfully by high intravenous dose of methyl-prednisolone or polyclonal anti-T-cell antibodies. A 6 month to 10 years follow-up showed all the donors kept normal kidney function without impairment of life quality, and 92 recipients with 92 grafts survived yet. Two recipients were dead: one due to serious pulmonary infection, and the other due to heart failure. 2 recipients underwent chronic allograft nephropathy.
CONCLUSION: Living-related donor kidney transplantation has optimal HLA matches, low incidence of acute rejection and long-term surviving ratio and blood relative, which is better for renal transplantation.