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21 May 2009

Potential living donor disqualification due to immunological factors

K Michalska, D Lewandowska, J Gozdowska, A Jałbrzykowska, I Sobierajska, M Durlik, M Nowaczyk

Ann Transplant 2009; 14(1): 69-69 :: ID: 880454


Background: The objective of the study was to analyze retrospectively immunological factors as the reason for potential living kidney donor disqualification.
Material/Methods: Between 1995-2008, 340 individuals who volunteered to
donate kidney to a related recipient were evaluated at our centre. In potential donors, CDC tests with a potential recipient was performed. In cases, in which the recipient was awaiting a consecutive transplantation and the result of his cross-match with a potential donor was negative, HLA antigen expression was examined in the donor to exclude any HLA incompatibilities with the potential donor.
Results: Of 340 living kidney donor candidates, 206 individuals (61.5%) were
disqualified. Of these, 31 individuals (27%) were disqualified due to immunological reasons. In 23 individuals, the reason for disqualification was positive or doubtfully false result of the CDC test with the recipient. 3 individuals were disqualified in spite of the negative result of the cross-match due to the repetition of incompatibility, that is due to having the same HLA antigens that were found in the previous donor and were not present in the recipient. In 6 cases, the reason for disqualification was blood group incompatibility or a complete lack of HLA antigen compatibility (currently it is not an absolute contraindication).
Conclusions: Our results show that immunological factors constitute an important problem when selecting a living donor, especially for patients awaiting consecutive transplantations and immunized patients, even those in whom low titers of antibodies are found. In some cases, an advanced clinical examination of the donor should be preceded by an extended panel of immunological tests.

Keywords: Living Donor

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358