Kidney shortage is the main factor limiting the development of kidney transplantation, and living kidney transplantation from relatives is an effective way to alleviate the shortage of kidneys. As the number of family members in China gradually decreases, blood type incompatibility between relatives of donors and recipients is becoming more and more common. In the early days, it was believed that since blood type incompatibility can lead to hyperacute rejection and loss of function of the transplanted kidney, ABO blood type matching between donors and recipients is a mandatory condition for organ transplantation. Later studies found that effective pre-transplantation pretreatment methods such as desensitization therapy can break through blood type barriers, making ABO blood type incompatible relative kidney transplantation possible.
At present, some transplant centers in China have successfully carried out ABO blood type incompatible relative kidney transplantation. As early as 2016, the kidney transplantation team of Zhongshan Hospital led by Professor Zhu Tongyu of our hospital (Chief Physician Xu Ming and Chief Physician Rong Ruiming completed laparoscopic donor kidney extraction and kidney transplantation respectively) successfully helped 47-year-old mother Jiang donate her left kidney to her 24-year-old son Xiaojiang on the basis of summarizing the experience of predecessors. The operation was very smooth and the patient recovered well after the operation. This was also the first ABO blood type incompatible relative kidney transplantation in Shanghai. If ABO-incompatible kidney transplantation can be promoted, it means that the number of kidney donors can be increased by about 1/3, which will give more uremic patients the opportunity to receive kidney transplantation.
The indications for ABO-incompatible relative kidney transplantation are basically the same as those for ABO-compatible relative kidney transplantation. ABO-incompatible relative kidney transplantation is particularly suitable for uremic patients who are unable to find ABO-compatible kidney sources in the short term, have poor dialysis treatment effects, have many complications, are in life-threatening situations, and cannot accept other renal replacement therapies. Other indications include: (1) various types of glomerulonephritis; (2) hereditary diseases such as polycystic kidney disease; (3) metabolic diseases such as diabetes; (4) obstructive nephropathy; (5) drug-induced renal injury; (6) systemic diseases such as systemic lupus erythematosus; (7) hemolytic uremic syndrome; (8) congenital diseases such as horseshoe kidney; (9) irreversible acute renal failure; (10) patients with bilateral or solitary kidney loss due to trauma.
After reading this, do you know whether you are suitable for ABO blood type incompatible relative kidney transplant? If you have any questions, the Kidney Transplant Center of Zhongshan Hospital Affiliated to Fudan University welcomes your consultation.
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