PMID- 10925549
OWN - NLM
STAT- MEDLINE
DCOM- 20000817
LR  - 20161013
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 99
IP  - 6
DP  - 2000 Jun
TI  - Effectiveness of an organ-sharing program in providing zero HLA-A,B,DR mismatched 
      kidneys for transplantation in Taiwan.
PG  - 447-52
AB  - PURPOSE: This study evaluated the effects of organ sharing on the allocation of 
      kidneys from cadaveric donors to uremic patients from National Cheng Kung 
      University Hospital (CKUH) and National Taiwan University Hospital (NTUH) who 
      were waiting for kidney transplantation. METHODS: Standard complement-dependent 
      microcytotoxicity assays were used. Human leukocyte antigen (HLA)-A,B,C typing 
      was performed on nylon-wool-enriched T lymphocytes. HLA-DR typing was performed 
      on either nylon-wool-separated B cells or Dynabeads. Isolation of class 
      II-positive cells was performed with commercial typing trays. RESULTS: Organs 
      were allocated from a total of 88 cadaveric donors to 320 patients treated at 
      CKUH and 179 patients treated at NTUH. Cadaveric kidneys could be allocated with 
      an A,B,DR mismatch to 6.9% of CKUH patients and to 4.7% of NTUH patients. When 
      CKUH and NTUH patients were pooled, the total number of kidneys that could be 
      allocated with 0-A,B,DR mismatch increased to 13.3% (p < 0.004). However, when 
      allocation was assessed using 10,000 potential bone marrow donors instead of the 
      88 cadaveric donors, kidneys could have been allocated with 0-A,B,DR mismatch to 
      12% (p = 0.64) of patients. No significant benefit was found when allocation 
      estimates from the 10,000 potential bone marrow donors were compared with those 
      for the 88 cadaveric donors. Use of epitope matching resulted in a 0-A,B 
      cross-reactive epitope group, and a 0-DR mismatch allocation rate of 36.4% in 
      CKUH patients and 31.8% in NTUH patients. This rate increased to 54.6% (p < 
      0.001) when the patients from these hospitals were pooled. CONCLUSION: The 
      results of this study demonstrate that the pooling of patients among regional 
      transplant centers in Taiwan can significantly enhance the benefits of an organ 
      donation program through better HLA matching.
FAU - Lee, P C
AU  - Lee PC
AD  - Department of Surgery, College of Medicine, National Cheng Kung University, 
      Tainan, Taiwan.
FAU - Lee, P H
AU  - Lee PH
FAU - Shaw, C K
AU  - Shaw CK
FAU - Lei, H Y
AU  - Lei HY
FAU - Chen, J C
AU  - Chen JC
FAU - Takemoto, S
AU  - Takemoto S
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - HLA-A Antigens/*immunology
MH  - HLA-B Antigens/*immunology
MH  - HLA-DR Antigens/*immunology
MH  - *Histocompatibility Testing
MH  - Humans
MH  - *Kidney Transplantation
EDAT- 2000/08/05 11:00
MHDA- 2000/08/19 11:00
CRDT- 2000/08/05 11:00
PHST- 2000/08/05 11:00 [pubmed]
PHST- 2000/08/19 11:00 [medline]
PHST- 2000/08/05 11:00 [entrez]
PST - ppublish
SO  - J Formos Med Assoc. 2000 Jun;99(6):447-52.