title: Options for successful renal transplantation in recipients with incompatible living donors: Severance Hospital experience.
abstract: Exchange donor programs and desensitization protocols are available options for ABO-incompatible and positive cross-match living donor kidney transplantations. Patient and donor blood types, the degree of sensitization, and DSA titers should be considered to achieve successful kidney transplantation in recipients with incompatible living donors. Highly sensitized blood type O patients with ABO-incompatible living donors, or highly sensitized patients with a positive cross-match (with low DSA titer) to their AB donors should be considered for a desensitization protocol as a first priority. Narrowly sensitized patients with a positive cross-match (and high DSA titer) should be considered for an exchange donor program if possible. Patients with positive cross-match O donors can be easily matched and benefit from an exchange program. Exchange donor programs and desensitization protocols are complementary strategies to overcome HLA and ABO antibody barriers.
authors.affiliation: Severance Hospital Transplantation Center, Yonsei University Health System, Seoul, Korea.
authors.forename: Kyu Ha
authors.initials: KH
authors.lastname: Huh
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hyun Ok
authors.initials: HO
authors.lastname: Kim
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoo
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Kiil
authors.initials: K
authors.lastname: Park
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000046:Academic Medical Centers; D001787:Blood Group Incompatibility; D001788:Blood Grouping and Crossmatching; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D016730:Program Development; D015397:Program Evaluation; D056910:Republic of Korea; D013997:Time Factors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System