Increased access to transplantation for blood group B cadaveric waiting list candidates by using A2 kidneys:: Time for a new national system?

被引:43
作者
Nelson, PW
Shield, CF
Muruve, NA
Murillo, D
Warady, BA
Aeder, MI
Bryan, CF [1 ]
机构
[1] Midw Transplant Network, Westwood, KS 66205 USA
[2] St Lukes Hosp, Kansas City, MO 64111 USA
[3] Univ Missouri, Kansas City, MO 64110 USA
[4] Via Christi St Francis Reg Med Ctr, Wichita, KS USA
[5] Univ Hosp Columbia, Columbia, MO USA
[6] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA
[7] Childrens Mercy Hosp, Kansas City, MO 64108 USA
[8] Med Res Ctr, Kansas City, MO USA
关键词
A(2) to B; access; kidney transplant; UNOS variance;
D O I
10.1034/j.1600-6143.2002.020115.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Since blood group B end-stage renal disease (ESRD) patients have less access to donor kidneys and a higher minority composition than any other blood group, the United Network for Organ Sharing (UNOS) approved a voluntary national kidney allocation variance to allow organ procurement organizations (OPOs) to preferentially allocate A(2) and A(2)B kidneys to B candidates. The Midwest Transplant Network OPO has preferentially allocated and transplanted kidneys from blood group A(2) and A(2)B donors to our blood group B waiting list candidates for more than 7 years to increase access to kidneys for the B candidates on our OPO-wide waiting list. Between 1994 and 2000, a total of 121 blood group B ESRD patients from our OPO-wide cadaveric kidney waiting list were transplanted. Thirty-four per cent (41/121) of those B candidates received either an A(2) or an A(2)B kidney. One- and 5-year graft survival rates for the group of B recipients of A(2) or A(2)B kidneys were 91 and 85% (died with functioning graft [DWFG] censored), respectively, which were not significantly different from those of 91 and 80% for the 80 B recipients of B or O kidneys (Wilcoxon = 0.48; log-rank = 0.55). These data support the national trial for additional OPOs to voluntarily allocate A(2) and A(2)B kidneys preferentially to B waiting list candidates, thus increasing access of blood group B patients to renal transplantation.
引用
收藏
页码:94 / 99
页数:6
相关论文
共 17 条
[1]   Barriers to cadaveric renal transplantation among blacks, women, and the poor [J].
Alexander, GC ;
Sehgal, AR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (13) :1148-1152
[2]   Renal transplantation across the ABO barrier using A2 kidneys [J].
Alkhunaizi, AM ;
de Mattos, AM ;
Barry, JM ;
Bennett, WM ;
Norman, DJ .
TRANSPLANTATION, 1999, 67 (10) :1319-1324
[3]   The effect of patients' preferences on racial differences in access to renal transplantation [J].
Ayanian, JZ ;
Cleary, PD ;
Weissman, JS ;
Epstein, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (22) :1661-1669
[4]   DISTRIBUTION OF BLOOD-GROUP ANTIGEN-A IN NORMAL AND PATHOLOGIC HUMAN KIDNEYS [J].
BARIETY, J ;
ORIOL, R ;
HINGLAIS, N ;
ZANETTI, M ;
BRETTON, R ;
DALIX, AM ;
MANDET, C .
KIDNEY INTERNATIONAL, 1980, 17 (06) :820-826
[5]   FLOW-CYTOMETRIC ANALYSIS OF ERYTHROCYTIC BLOOD GROUP-A ANTIGEN DENSITY PROFILE [J].
BERNEMAN, ZN ;
VANBOCKSTAELE, DR ;
UYTTENBROECK, WM ;
VANZAELEN, C ;
COLEDERGENT, J ;
MUYLLE, L ;
PEETERMANS, ME .
VOX SANGUINIS, 1991, 61 (04) :265-274
[6]   Transplantation rate of the blood group B waiting list is increased by using A2 and A2B kidneys [J].
Bryan, CF ;
Shield, CF ;
Nelson, PW ;
Pierce, GE ;
Ross, G ;
Luger, AM ;
Warady, BA ;
Helling, TS ;
Aeder, MI ;
Martinez, J ;
Hughes, TR ;
Beck, ML ;
Harrell, KM .
TRANSPLANTATION, 1998, 66 (12) :1714-1717
[7]   Racial disparities in access to renal transplantation - Clinically appropriate or due to underuse or overuse? [J].
Epstein, AM ;
Ayanian, JZ ;
Keogh, JH ;
Noonan, SJ ;
Armistead, N ;
Cleary, PD ;
Weissman, JS ;
David-Kasdan, JA ;
Carlson, D ;
Fuller, J ;
Marsh, D ;
Conti, RM .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (21) :1537-U8
[8]  
KASISKE BL, 1991, NEW ENGL J MED, V324, P301
[9]  
Nelson PW, 1998, TRANSPLANTATION, V65, P256
[10]   CURRENT EXPERIENCE WITH RENAL-TRANSPLANTATION ACROSS THE ABO BARRIER [J].
NELSON, PW ;
HELLING, TS ;
SHIELD, CF ;
BECK, M ;
BRYAN, CF .
AMERICAN JOURNAL OF SURGERY, 1992, 164 (05) :541-545