CURRENT TECHNOLOGIES AND CLINICAL TRIALS IN KIDNEY TRANSPLANTATION

Abstract

Since 1999 living-donor kidney transplantation (LDKT) is one of the priorities in the work of our Center. More than 45% of kidney transplants performed annually are the LDKTs. Long-term outcomes of the fi rst 357 LDKTs demonstrate good 10-year patient and graft survival: 93,5% and 73,0%, respectively. In this group we identify the risk factors of poor graft survival: age of the recipient less than 18 years, duration of dialysis before transplantation more than 24 months and creatinine level at discharge more than 130 mmol/L. The next step was the introduction of laparoscopic donor nephrectomy in clinical practice in 2009. In 2011 we start the AB0-incompatibleLDKT (iAB0) program. Effective desensitization procedure and satisfactory results of iAB0 transplants (3-year patient and graft survival: 100% and 87.5%, respectively), as well as the availability of Luminex technology allowed us to start the clinical trials in patients with pre-existing high levels of anti-HLA antibodies. In this article we both analyze our current results, and focus on topical issues requiring further research.

Keywords

• kidney transplantation
• survival
• blood group incompatibility
• graft rejection