title: Kidney Swap in Pakistan: Experience at the Sindh Institute of Urology and Transplantation.
abstract: Kidney paired exchange is an established method of overcoming incompatibility in donor-recipient pairs and expanding the living-donor pool. It is infrequently performed in developing countries. We report the first kidney paired exchange in Pakistan, successfully performed at our center. One donor-recipient pair consisted of a 38-year-old female recipient (blood type, B positive) and her 40-year-old husband (A positive) as the potential donor. The second pair consisted of a 30-year-old male recipient (A positive) and his 30-year-old wife (B positive) as the potential donor. The donors were exchanged with the recipients, and both pairs were antigen matched for human leukocyte antigen A and human leukocyte antigen DR. Luminex antibody screening was negative, as were the crossmatches for T and B cells and for IgG and IgM. The transplant procedures and recoveries proceeded uneventfully. The recipients are maintaining serum creatinine levels around 0.78 mg/dL and 0.90 mg/dL, 1 year after transplant. Kidney paired exchange is a relatively low-cost option for overcoming the barrier of incompatibility in a resource-constrained setting.
authors.affiliation: Department of Medical Social Welfare, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors.forename: Naveeda
authors.initials: N
authors.lastname: Nizam
authors.forename: Farida
authors.initials: F
authors.lastname: Mazhar
authors.forename: Khawar
authors.initials: K
authors.lastname: Abbas
authors.forename: Tahir
authors.initials: T
authors.lastname: Aziz
authors.forename: Mirza Naqir
authors.initials: MN
authors.lastname: Zafar
authors.forename: Rehan
authors.initials: R
authors.lastname: Mohsin
authors.forename: Bux
authors.initials: B
authors.lastname: Ali
authors.forename: Asad
authors.initials: A
authors.lastname: Shahzad
authors.forename: Mohammed
authors.initials: M
authors.lastname: Imran
authors.forename: Syed Adibul Hasan
authors.initials: SA
authors.lastname: Rizvi
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001787:Blood Group Incompatibility / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D002985:Clinical Protocols; D033001:Directed Tissue Donation; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D010154:Pakistan; D013997:Time Factors
chemical_list: D000017:ABO Blood-Group System; D015415:Biomarkers; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies