First renal transplant chain involving an altruistic donor performed in Spain

Breda, A.; Rodríguez Faba, O.; Espejo, E.; Cozar, J.M.; Villavicencio, H.

doi:10.1016/j.acuroe.2012.05.011

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In these cases, the alternative is a long waiting list for cadaveric donors, or desensitization protocols with plasmapheresis/immunoabsorption and intravenous immunoglobulins.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Both alternatives have shown an overall graft survival lower than those from negative cross match pairs.In this scenario, the possibility of getting a kidney from a negative cross match living donor from a transplant chain program initiated by an altruistic donor, also called ‘Good Samaritan’, represents a very attractive option for these patients. The first chain of transplants was performed in the U.S. in 2006,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and it currently has wide acceptance in countries such as Korea and Holland.<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> In order to achieve compatibility between the patients, the National Kidney Registry (<a href="http://www.%20kidneyregistry.org/">www. kidneyregistry.org</a>) has the necessary software available to get up to a trillion chance of crossing starting from a small number of pairs entered into the program.Although the chain principles consider the performance of donations and transplantations non-simultaneously to create a large number of transplants, our chain began and ended on the same day to avoid the risk that any member reconsidered the donation and abandoned it. Thus, jointly between the Fundació Puigvert (FP) and the Hospital Virgen de las Nieves (HVN), the first chain of transplants performed in Spain was carried out on April 6, 2011. The procedure began at 9AM with the living donor nephrectomies performed simultaneously with the altruistic donor and the other two donors. The kidney from the altruistic donor was transplanted into ‘B’ immediately after the extraction in the PF. The kidney of ‘A’ was sent to HVN in a commercial flight. The trip lasted 2.5h and the kidney was transplanted into ‘D’ after 4h of cold ischemia at the HVN. During this time, the kidney of ‘C’ remained in cold ischemia until the plane that landed in Granada came back to Barcelona and was transplanted in ‘E’ with 5h and 15min of cold ischemia. At 7:30PM, the transplant was completed and the chain was closed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The donors of both hospitals were discharged at 3 and 4 days, respectively. Two of the three recipients were discharged on the seventh day with a creatinine of 1.2 and 1.4mg/dl. The third recipient showed a perirenal hematoma which required surgical revision, being discharged on the tenth day with creatinine of 1.2mg/dl. The experience with the first chain of transplants performed in Spain has been very positive, considering that three receptors have been transplanted thanks to an altruistic donor. This new pathway in renal transplantation opens the door to a large number of patients who could potentially benefit from this possibility." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Breda A, et al. Primera cadena de trasplantes a partir de un donante altruista realizada en España. Actas Urol Esp. 2012;36:196–7." ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1253 "Ancho" => 2508 "Tamanyo" => 139684 ] ] "descripcion" => array:1 [ "en" => "Renal transplant chain involving an altruistic donor." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "United Network for Organ Sharing (UNOS). Available from: <a class="elsevierStyleInterRef" href="http://www.unos.org/">www.unos.org</a> [accessed 03.11.08]." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Present situation of living-donor kidney transplantation in Spain and other countries: past, present and future of an excellent therapeutic option" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B. Domínguez-Gil" 1 => "M. de la Oliva Valentín" 2 => "E. Martín Escobar" 3 => "J.M. Cruzado" 4 => "J. Pascual" 5 => "G. Fernández Fresnedo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2010.Nov.10686" "Revista" => array:7 [ "tituloSerie" => "Nefrologia" "fecha" => "2010" "volumen" => "30" "numero" => "Suppl. 2" "paginaInicial" => "3" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21183958" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Takahashi" 1 => "K. Saito" 2 => "S. Takahara" 3 => "A. Okuyama" 4 => "K. Tanabe" 5 => "H. 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Reece" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Clin Transpl" "fecha" => "2009" "paginaInicial" => "235" "paginaFinal" => "246" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Dutch national living donor kidney exchange program" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. de Klerk" 1 => "K.M. Keizer" 2 => "F.H. Claas" 3 => "M. Witvliet" 4 => "B.J. Haase-Kromwijk" 5 => "W. Weimar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-6143.2005.01024.x" "Revista" => array:6 [ "tituloSerie" => "Am J Transplant" "fecha" => "2005" "volumen" => "5" "paginaInicial" => "2302" "paginaFinal" => "2305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16095513" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exchange donor program in kidney transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Park" 1 => "J.I. Moon" 2 => "S.I. Kim" 3 => "Y.S. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Transplantation" "fecha" => "1999" "volumen" => "67" "paginaInicial" => "336" "paginaFinal" => "338" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10075605" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016510708016465" "estado" => "S300" "issn" => "00165107" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000003600000003/v1_201304251809/S2173578612000856/v1_201304251809/en/main.assets" "Apartado" => array:4 [ "identificador" => "6306" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000003600000003/v1_201304251809/S2173578612000856/v1_201304251809/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578612000856?idApp=UINPBA00004N"]

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Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided. It has high visibility and accessibility and is found in the most important data bases, Medline/Pubmed, Emabase, JCR, Ïndice Médico Español, Índice bibliográfico Español en Ciencias de la Salud (IBECS), Cuiden, Dialnet, Hinari, Scopus, Google Scholar.

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