Spousal renal donor transplantation in Chinese subjects: a 10 year experience from a single centre

• Published in: Nephrology, dialysis, transplantation Vol. 19; no. 1; pp. 203 - 206
• Main Authors: Tang, Sydney, Lui, Sing Leung, Lo, Chi Yuen, Lo, Wai Kei, Cheng, Ignatius K. P., Lai, Kar Neng, Chan, Tak Mao
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-01-2004
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: renal failure. Dialysis management; ethics; Ethics, Medical; Family; Female; Graft Survival; Hong Kong; Humans; Intensive care medicine; Kidney Failure, Chronic - therapy; Kidney Transplantation - ethics; Kidney Transplantation - methods; Living Donors - ethics; Living Donors - supply & distribution; living-related donor; Male; Medical sciences; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; outcome; Renal failure; renal transplantation; spousal donor; Spouses; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Treatment Outcome; Hong Kong; Kidney disease; Human; Urinary system disease; Prognosis; Hemodialysis; Living donor; renal transplantation; Related donor; spousal donor; Extrarenal dialysis; Ethics; living-related donor; Renal failure; Chinese; outcome
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfg492

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.