Featured Research

from universities, journals, and other organizations

Living donor exchange poses new option for liver transplantation

Date:
April 2, 2010
Source:
Wiley - Blackwell
Summary:
Two major transplant centers in Hong Kong and South Korea released results from their paired donor exchange programs for living donor liver transplantation (LDLT). A single paired exchange, performed by the Hong Kong team under emergency circumstances, was a success. The Korean team reported 16 donor exchanges conducted over a 6-year period were successful.

Two major transplant centers in Hong Kong and South Korea released results from their paired donor exchange programs for living donor liver transplantation (LDLT). A single paired exchange, performed by the Hong Kong team under emergency circumstances, was a success. The Korean team reported 16 donor exchanges conducted over a 6-year period were successful.

Related Articles


Full details of this novel approach to organ transplantation appear in the April issue of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).

Living donor transplantation has emerged as an alternative to the shortage of deceased donor organs, and in some parts of the world represents almost the only alternative for liver transplantation. However, many patients in need find that family members who are willing to donate organs have incompatible blood types. As a result, transplant centers worldwide are establishing coordinated donor exchange programs, where living donors are matched with medically acceptable and blood group compatible recipients in cases where the original intended recipient is not blood group compatible with their donor.

Paired donor exchange programs were adopted at two major transplant centers-The University of Hong Kong, Queen Mary Hospital, and the ASAN Medical Center, Seoul. Performing ABO-incompatible LDLTs, another practice that has emerged in response to the lack of blood-group compatible organs, generally requires a more stringent immunosuppressive regimen to allow the body to accept the organ. While this method has achieved some success, ABO-incompatible LDLT has a 5-year survival rate of only 52%. In addition, the heavier immunosuppressive regimen has uncertain long-term consequences and compromised quality of life.

Donor exchange programs appear to be an ideal solution to the shortage when only blood-group incompatible donors exist for a specific recipient. However, cultural obstacles to the idea exist. Lead researcher of the Korean team, Sung-Gyu Lee, M.D., explained, "The establishment of a paired exchange living-donor kidney transplantation program in Korea suggested that a similar program for LDLT would be acceptable in our country. In other Asian countries, such as Japan, where the availability of deceased donors is much less than in Korea, these programs may not be generally accepted." In Japan, the concept of giving or receiving organs to or from unrelated donors is not an accepted practice.

The donor exchange practice also raises ethical concerns, specifically, that all donors involved must understand the potential risks to their own health, as well as the possibility that while the recipient of their donated organ may survive, their own relative, for whose benefit they have entered into the exchange program, may experience an adverse outcome.

Chung Mau Lo, M.D., lead researcher of the Hong Kong team, commented, "Prior psychological evaluation and preparation in anticipation of possible scenarios are crucial in minimizing donor difficulties when confronting such mishaps. In fact, the donor should have a mindset that only with another compatible but unrelated donor donating, can the related recipient have an opportunity to undergo the LDLT." Furthermore, to ensure that all donors comply regardless of the surgical outcome, the LDLT operations must be conducted simultaneously, which may raise logistical issues.

Both transplant centers achieved high success rates, with all donors and all but one recipient making complete recoveries. Both teams conclude exchange donor programs for LDLT are a viable alternative to donor ABO-incompatibility and should become accepted in countries where paired exchange programs for living-donor kidney transplantation have already been established.


Story Source:

The above story is based on materials provided by Wiley - Blackwell. Note: Materials may be edited for content and length.


Journal References:

  1. Shin Hwang, Sung-Gyu Lee, Deok-Bog Moon, Gi-Won Song, Chul-Soo Ahn, Ki-Hun Kim, Tae-Yong Ha, Dong-Hwan Jung, Kwan-Woo Kim, Nam-Kyu Choi. Exchange living donor liver transplantation to overcome ABO incompatibility in adult patients. Liver Transplantation, 2010; NA DOI: 10.1002/lt.22017
  2. See Ching Chan, Chung Mau Lo, Boon Hun Yong, Wilson J.C. Tsui, Kelvin K. Ng, Sheung Tat Fan. Paired donor interchange to avoid ABO-incompatible living donor liver transplantation. Liver Transplantation, 2010; 16 (4): 478 DOI: 10.1002/lt.21970

Cite This Page:

Wiley - Blackwell. "Living donor exchange poses new option for liver transplantation." ScienceDaily. ScienceDaily, 2 April 2010. <www.sciencedaily.com/releases/2010/04/100401101808.htm>.
Wiley - Blackwell. (2010, April 2). Living donor exchange poses new option for liver transplantation. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2010/04/100401101808.htm
Wiley - Blackwell. "Living donor exchange poses new option for liver transplantation." ScienceDaily. www.sciencedaily.com/releases/2010/04/100401101808.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Christmas Kissing Good for Health

Christmas Kissing Good for Health

Reuters - Innovations Video Online (Dec. 22, 2014) Scientists in Amsterdam say couples transfer tens of millions of microbes when they kiss, encouraging healthy exposure to bacteria. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Brain-Dwelling Tapeworm Reveals Genetic Secrets

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Reuters - Innovations Video Online (Dec. 22, 2014) Cambridge scientists have unravelled the genetic code of a rare tapeworm that lived inside a patient's brain for at least four year. Researchers hope it will present new opportunities to diagnose and treat this invasive parasite. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins