Spousal renal donor transplantation in Chinese subjects: a 10 year experience from a single centre.
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.
Tang
Sydney
S
Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.
Lui
Sing Leung
SL
Lo
Chi Yuen
CY
Lo
Wai Kei
WK
Cheng
Ignatius K P
IK
Lai
Kar Neng
KN
Chan
Tak Mao
TM
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