Activation Policy for Brain-dead Organ Donation / 이화의대지

Organ transplantation has become the standard of care for treatment of end stage organ failure patients medically suitable for transplantation. Unfortunately, the availability of transplantable organs has not been able to meet the high demand. The organ shortage of transplantation has become worldwide and a national crisis. Despite various attempts to expand the donor pool, the difference between organ supply and organ demand continues. This article reviews methods to increase the number of potential deceased organ donor and the number of organs per donor by aggressive donor management protocol.

Exchange Living-donor Kidney Transplantation: The Present and Future

The shortage of donor organs is one of the major barriers of transplantation worldwide. After the success of the direct exchange donor (swap) program in Korea since 1991, a swaparound program has been developed. Recently, a web-based (computerized) algorithm to facilitate donor kidney exchange was devised and tested in multi-center settings. An excellent longterm outcome was achieved by using the donor exchange program as an option to reduce the donor organ shortage. Herein, we discussed on the current status of the exchange donor renal transplantation in Korea, a couple of problems we have had, and future directions we have to head and make better to improve organ donation activities.

The Outcome of Renal Transplantation Using Exchange Donor Program / 대한이식학회지

PURPOSE: The availability of living donors is the major limiting factor in living related kidney transplantion. In 1997, Ross et al. proposed that the living unrelated kidney transplantation through exchange arrangement of ABO-incompatible donors-recipient pairs to expand donor pool is ethically acceptable as living related kidney transplantation. We analyzed exchange donor program whether this could expand the kidney donor pool in living donor renal transplantation. METHODS: We retrospectively reviewed the records of the 121 exchange donor renal transplantations performed from 1991 to 2005 in our center. Recipient's and donor's mean age were 38.8 (15~64) and 40.4 (21~60) year-old, respectively. Mean follow up period is 81 months (1~170). The reasons of exchanging donor were ABO incompatibility (92/121, 76%), positive HLA cross matching (20/121, 16%) and patients who received kidneys from unknown volunteer donors (9/121, 7%). We compared graft survival and acute rejection rate of exchange donor group and living related donor group. RESULTS: The graft survival rate (1, 5, 10 year) of exchange donor group (92%, 80.6%, 72%) was similar to living related donor groups (95%, 77%, 66%). The acute rejection rate were 34% (42/121 ) and 24%, respectively. We have observed acute rejections during the same time in both groups from 1991 to 2005. Although acute rejection rate of exchange donor group is higher, we see the similar survival rate of transplanted kidneys in exchange donor group. CONCLUSION: We suggest that exchange donor program could expand the donor pool in living donor renal transplantation, when recipient cannot receive kidney from healthy donor because of ABO incompatibility or positive HLA cross matching.