Author/Editor     Bohinjec, M; Vidan-Jeras, B; Jurca, B; Jeras, M
Title     Izbira možnih sprejemalcev za transplantacijo ledvice umrlih dajalcev v Sloveniji - imunogenetska merila
Type     članek
Source     In: Lindič J, Kaplan-Pavlovčič S, editors. Zbornik prispevkov 1. slovenski nefrološki kongres z mednarodno udeležbo; 1996 okt 23-26; Portorož. Ljubljana: Klinični center, Nefrološka klinika,
Publication year     2000
Volume     str. 214-8
Language     slo
Abstract     Cadaveric kidney transplantation in Slovenia depends exclusively on organs retrieved by the regional donor center. To optimize the transplantation success-rate we are following a protocol which enables us to select among patients on the waiting list recipients with the highest level of histocompatibility and the lowest potential immunological risk with regard to the given donor. The following information on potential kidney recipients is available from the database at the Tissue Typing Center: blood group ABO, phenotype HLA-A, B, DR, level of panel reactive lymphocytotoxic alloantibodies throughout the pretransplant period. ldentified specificities of HLA alloreactive antibodies are declared as "prohibited missmataches". The recipient selection is performed in three subsequent steps. Step 1. Exclusion from further consideration of patients incompatible with the donor. The potential donor is typed for ABO blood groups and HLA antigens. Parallel to serologic typing of the donor, a collective cross-match test is performed using his lymphcytes and current sera of all ABO compatible patients on the waiting list. Patients with donor specific cytotoxins are definitely excluded. Equally excluded are patients if forbidden mismatches with the donor are in question. Step 2. Selection of recipients based on HLA matching with the donor. The patients not excluded by previous criteria are ranked according to the number of matching antigens, respecting the following hierarchy: HLA-DR > HLA-B > HLA-A. Step 3. Patients of the highest rank are clinically evaluated. In those proposed as candidates for transplantation, a pre-transplant cross-match is performed. A negative outcome of the test is obligatory.
Descriptors     KIDNEY TRANSPLANTATION
CADAVER
TISSUE DONORS
HISTOCOMPATIBILITY TESTING
HLA ANTIGENS
TRANSPLANTATION IMMUNOLOGY