Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors

Babak J Orandi1, Xun Luo1, Allan B Massie1

  • 1From the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (B.J.O., X.L., A.B.M., B.E.L., R.A., K.J.V.A., R.A.M., D.L. Segev); the Department of Surgery, Barnes-Jewish Hospital, St. Louis (J.M.G.-W., J.W.); the Department of Surgery, Mayo Clinic, Rochester (M.D.S.), and the Department of Surgery, University of Minnesota, Minneapolis (T.B.D.) - both in Minnesota; the Department of Medicine, Cedars-Sinai Comprehensive Transplant Center, Los Angeles (S.C.J.), the Department of Surgery, University of California,San Francisco, San Francisco (J.P.R.), the Department of Surgery, Stanford University, Palo Alto (M.L.M.), and the Department of Surgery, Scripps Clinic and Green Hospital, La Jolla (C.L.M.) - all in California; the Department of Surgery, University of Illinois-Chicago, Chicago (J.O.); the Department of Surgery, Columbia University Medical Center (L.E.R.), and the Department of Surgery, New York Presbyterian-Weill Cornell Medical Center (S.K.) - both in New York; the Department of Surgery, Ohio State University, Columbus (R.P.P.), the Department of Urology, University of Toledo Medical Center, Toledo (M.A.R.), and the Department of Urology, Cleveland Clinic, Cleveland (B.R.S.) - all in Ohio; the Department of Medicine, Thomas Jefferson University Hospital, Philadelphia (P.S.); the Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh (R.S.); the Department of Surgery, Duke University Medical Center, Durham (D.L. Sudan), and the Department of Surgery, University of North Carolina School of Medicine, Chapel Hill (D.A.G.) - both in North Carolina; the Department of Surgery, Virginia Commonwealth University, Richmond (M.P.P.); Integris Baptist Medical Center, Transplant Division, Oklahoma City (J.M.E.-A.); Medstar Georgetown Transplant Institute, Washington, DC (M.C.); the Department of Surgery, Baystate Medical Center, Springfield (G.S.L.), and the Department of Surgery, University of Massachusetts Memorial Medical Ce

Summary

Kidney transplants from human leukocyte antigen (HLA)-incompatible live donors significantly improve patient survival compared to waiting lists. This multicenter study confirms a survival benefit across various cross-match levels.

Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
681
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
751
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
554
Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
2.3K
Tissue Transplantation01:24

Tissue Transplantation

Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
1.2K