Navigation Links
Living donor exchange poses new option for liver transplantation
Date:4/1/2010

Two major transplant centers in Hong Kong and South Korea released results from their paired donor exchange programs for living donor liver transplantation (LDLT). A single paired exchange, performed by the Hong Kong team under emergency circumstances, was a success. The Korean team reported 16 donor exchanges conducted over a 6-year period were successful. Full details of this novel approach to organ transplantation appear in the April issue of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).

Living donor transplantation has emerged as an alternative to the shortage of deceased donor organs, and in some parts of the world represents almost the only alternative for liver transplantation. However, many patients in need find that family members who are willing to donate organs have incompatible blood types. As a result, transplant centers worldwide are establishing coordinated donor exchange programs, where living donors are matched with medically acceptable and blood group compatible recipients in cases where the original intended recipient is not blood group compatible with their donor.

Paired donor exchange programs were adopted at two major transplant centersThe University of Hong Kong, Queen Mary Hospital, and the ASAN Medical Center, Seoul. Performing ABO-incompatible LDLTs, another practice that has emerged in response to the lack of blood-group compatible organs, generally requires a more stringent immunosuppressive regimen to allow the body to accept the organ. While this method has achieved some success, ABO-incompatible LDLT has a 5-year survival rate of only 52%. In addition, the heavier immunosuppressive regimen has uncertain long-term consequences and compromised quality of life.

Donor exchange programs appear to be an ideal solution to the shortage when only blood-group incompatible donors exist for a specific recipient. However, cultural obstacles to the idea exist. Lead researcher of the Korean team, Sung-Gyu Lee, M.D., explained, "The establishment of a paired exchange living-donor kidney transplantation program in Korea suggested that a similar program for LDLT would be acceptable in our country. In other Asian countries, such as Japan, where the availability of deceased donors is much less than in Korea, these programs may not be generally accepted." In Japan, the concept of giving or receiving organs to or from unrelated donors is not an accepted practice.

The donor exchange practice also raises ethical concerns, specifically, that all donors involved must understand the potential risks to their own health, as well as the possibility that while the recipient of their donated organ may survive, their own relative, for whose benefit they have entered into the exchange program, may experience an adverse outcome.

Chung Mau Lo, M.D., lead researcher of the Hong Kong team, commented, "Prior psychological evaluation and preparation in anticipation of possible scenarios are crucial in minimizing donor difficulties when confronting such mishaps. In fact, the donor should have a mindset that only with another compatible but unrelated donor donating, can the related recipient have an opportunity to undergo the LDLT." Furthermore, to ensure that all donors comply regardless of the surgical outcome, the LDLT operations must be conducted simultaneously, which may raise logistical issues.

Both transplant centers achieved high success rates, with all donors and all but one recipient making complete recoveries. Both teams conclude exchange donor programs for LDLT are a viable alternative to donor ABO-incompatibility and should become accepted in countries where paired exchange programs for living-donor kidney transplantation have already been established.


'/>"/>

Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Discover the Ease of Healthy Living Today with Juice Plus Nutritional Products
2. A.C. Moore Arts & Crafts, Inc. Offers Creative Way to Help Easter Seals and Families Living with Autism
3. Healthy Living Adds Years to Life
4. Classic Residence by Hyatt at Teaneck Opens Licensed Assisted Living Center
5. Hearts and Minds Promotes Wellness; African Americans Living with Mental Illness Have Higher Risk for Other Illnesses.
6. Wyndemere Senior Living Community Acquired by Life Care Services
7. Regence Invests in Kinetix Living Corp.
8. KID HEALTHY-Steps to Healthy Living Kicks Off 2010 Campaign to Make Southern California Kids and Families Healthier
9. iTable Debuts at CeBIT 2010 to Revolutionize Your Living Room
10. Healthy Aging Global Leader Broadens Patient Exercise/Nutrition Success With Online Living Site
11. Nurtur Acquires ActivHealth and Wellness by Choice; Gains Exclusive Partnership with Duke University Center for Living
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... , ... February 12, 2016 , ... The law firm ... and Evangeline Parishes. The purpose of these scholarships is to encourage applicants to ... individuals to seek employment within these two parishes. , “We have available jobs ...
(Date:2/12/2016)... ... February 12, 2016 , ... ... to funding innovative lymphoma research and serving the lymphoma community through a comprehensive ... members of South Florida’s philanthropic community at its 10th anniversary Fashion Luncheon on ...
(Date:2/12/2016)... ... February 12, 2016 , ... Fixed Dose Combination Drug ... p.m. EST, http://www.fdanews.com/fixeddosecombination , Fixed dose combination products ... increased attention from all stakeholders in the development of new chemical entities. , ...
(Date:2/12/2016)... ... , ... As a former television executive, owner Tal Rabinowitz knows how stressful ... decompress, Rabinowitz found herself drawn to a casual meditation class while working at NBC ... implementing a 20-minute-per-day meditation practice with her team. After her tenure at NBC, she ...
(Date:2/12/2016)... ... February 12, 2016 , ... T.E.N., a technology and information ... ISE Southeast Awards 2016. Finalists and winners of the ISE® Awards for both ... and Awards Gala on March 15, 2016 at the Westin Peachtree Plaza, Atlanta. ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... Inc. (NYSE: DPLO ) is pleased to announce the promotion of Paul Urick ... 23, 2016. To learn more about our ... ... ... In his redefined ...
(Date:2/12/2016)... 12, 2016   HeartWare International, Inc . (NASDAQ: ... webcast to discuss its financial results for the three ... February 25, 2016 at 8:00 a.m. ET.  The company ... conference call and webcast.  On the conference call and ... from the fourth quarter and business outlook.   ...
(Date:2/12/2016)... 12, 2016  Sequent Medical, Inc. announced today that ... evaluate the safety and effectiveness of the WEB™ Aneurysm ... intracranial aneurysms.  Prof Laurent Spelle , MD, Head ... Paris, France and Principal Investigator of the ... France and Germany.  Although patients with ruptured ...
Breaking Medicine Technology: