title: Spousal renal donor transplantation in Chinese subjects: a 10 year experience from a single centre.
abstract: BACKGROUND
  The shortage of cadaveric kidneys for renal transplantation is a particularly problematic situation in the locality of Hong Kong. Kidneys from spousal donors are therefore increasingly being used for transplantation. This study was undertaken to evaluate the outcome of spousal donor transplant recipients in comparison with that of genetically related living donor (LRD) allograft recipients.
  
  
  METHODS
  From 1988, we have transplanted 22 spousal kidney recipients (group 1). All donors must demonstrate a genuine spousal relationship. Their outcome was compared with that of 24 LRD allograft recipients (group 2) transplanted in the same period with similar demographics, pre-transplant dialysis duration, immunosuppressive protocol and length of post-transplant follow-up.
  
  
  RESULTS
  The mean (+/-SD) age was 36.5 +/- 8 and 32.5 +/- 6 years for groups 1 and 2, who were followed for 56.6 +/- 35 and 59.1 +/- 38 months, respectively. There was no difference in the incidence of delayed graft function, acute rejection and serum creatinine level at 5 years. Graft survival rates were 86.4 and 79.2% (P = 0.56), while patient survival rates were 100 and 91.7% (P = 0.171) at 5 years for groups 1 and 2, respectively.
  
  
  CONCLUSIONS
  Spousal kidney transplantation shares comparable results with LRD transplantation and should be encouraged in places where cadaveric organs remain scarce. Stringent measures must be implemented to prevent the possible emergence of kidney bartering and to protect the interests of living donors. The ethical and social issues regarding the spousal donor in Hong Kong and other countries are discussed.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.
authors.forename: Sydney
authors.initials: S
authors.lastname: Tang
authors.forename: Sing Leung
authors.initials: SL
authors.lastname: Lui
authors.forename: Chi Yuen
authors.initials: CY
authors.lastname: Lo
authors.forename: Wai Kei
authors.initials: WK
authors.lastname: Lo
authors.forename: Ignatius K P
authors.initials: IK
authors.lastname: Cheng
authors.forename: Kar Neng
authors.initials: KN
authors.lastname: Lai
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
mesh_terms: D000328:Adult; D004992:Ethics, Medical; D005190:Family; D005260:Female; D006085:Graft Survival; D006723:Hong Kong; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000941:ethics* / Q000379:methods*; D019520:Living Donors / Q000941:ethics* / Q000600:supply & distribution; D008297:Male; D018454:Spouses; D016896:Treatment Outcome