Impact And Clinical Analysis On Kidney Transplantation Opportunity Of Sensitized Recipients In The DCD Times

BackgroundThe ever increasing scarcity of donor organs has become a global problem,especially for those who has exposed to foreign human leukocyte antigens(HLA)through either pregnancy,blood transfusions,or organ transplants can result in sensitization in the form of HLA antibodies.Sensitized patients in need of a kidney transplant have a lower chance of receiving a compatible donor organ as organ donors bearing the HLA antigens to which the patient has made antibodies are excluded.However,in China,organ procurement from executed prisoners has existed for several decades,yet this practice was abated on 1st January,2015.Whether the implementation of this regulation would affect the condition of kidney transplantation and outcomes in transplanted patients,especially sensitized recipients still remains unclear.ObjectiveIn this study,we analyzed the impact of the abolishment of organ procurement from executed prisoners in China on the rate of transplantation of sensitized and non-sensitized patients.We also evaluated the changes which occurred during post-abolishment in the demographic characteristics of our patients and donor populations,and post-transplant outcomes in sensitized and non-sensitized patients who received transplantation post-abolishment(2015-2017).Furthermore,we explored the outcomes of those patients in every single years,trying to find the changes among different times.Subjects and methodsFull stop death organ between before and after the period of January 1,2012 respectively to December 31,2014,and January 1,2015 to December 31,2017,all our registered on the kidney transplant patients(according to include and exclude standards),preoperative patients accept HLA genotyping,PRA detection and complement dependent trace lymphatic poison cross over(CDC)detection.ResultsAccording to the inclusion and exclusion criteria,126 patients underwent kidney transplantation in the first three years before the implementation of organ discontinuation through judicial channels,and 303 patients underwent kidney transplantation in the third years after the implementation of organ discontinuation through judicial channels as donors,with a significant increase in the overall number of cases.At the same time,the number of operation cases of sensitized kidney transplantation patients increased from 4 to 30,and there was a statistical significance in the operation opportunity of sensitized patients(X2=4.836,P=0.029).After 2015, there were no statistically significant differences in the incidence of acute rejection,reversal rate,DGF incidence,and short-term serum creatinine recovery between non-sensitized and sensitized kidney transplant recipients in 298 cases.In conclusionSince the implementation of the voluntary organ policy after the death of citizens after the complete deactivation of judicial organs,the total number of kidney failure patients undergoing kidney transplantation in our hospital has increased,especially the chance of the sensitized recipients receiving kidney transplantation has increased significantly.At the same time,in 2015 years on the kidney transplant between sensitization and the sensitization,the incidence of acute rejection,reversal rate,incidence of DGF,and follow-up and there was no significant difference between levels of serum creatinine restore,tips for kidney transplantation of sensitization to accept the high quality,suitable donor grafts,at the same time,our hospital in the bone marrow transplantation,donor maintenance and continuous improvement of the sensitized recipients processing experience,to give these patients more chance of survival.