| 特集名 | 腎移植 -- 新しいシステムをめぐって | |
|---|---|---|
| 題名 | 組織適合性検査とレシピエント選定 | |
| 発刊年月 | 1997年 11月 | |
| 著者 | 柏原 英彦 | 国立佐倉病院外科 |
| 【 要旨 】 | 腎移植(死体腎移植＝献腎移植)は，第三者からの善意による献腎によって初めて成り立つ医療であり，成績向上をはかりつつ，献腎の公平な配分を行うことが一般社会から移植医療が理解される要因である．かかる条件を満たす目的で1995年4月から，「(社)日本腎臓移植ネットワーク」が新たに発足した．献腎の配分基準は，以下のごとくである． 1)赤血球型(ABO型)の一致 2)ヒト組織適合性抗原(HLA型)の適合度が高い 3)上記の条件が同一の場合は待機期間が長い 4)直接リンパ球交差試験が陰性 5)HLA型が完全(6抗原)一致の場合は全国登録者を対象 発足から2年を経過した現在，献腎移植体制はほぼ整備され，この間の移植は約350例に達している．今後，成績の評価を待って基準の見直しなど体制の確立をはかっていく必要がある． |
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| Theme | Renal Transplantation under New Organ Sharing System in Japan | |
|---|---|---|
| Title | Histocompatibility test and recipient selection policies in the JKTN | |
| Author | Hidehiko Kashiwabara | Department of Surgery, National Sakura Hospital |
| [ Summary ] | Kidney transplantation is one of the treatment options for chronic renal failure. To promote cadaveric renal transplantation in Japan, graft survival must be improved and an organ procurement system is required to distribute the organs fairly. The Japan Kidney Transplant Network (JKTN), was established in 1995 to function as the national recipient registry for patients waiting for kidney transplantation and to serve as a computer network providing graft allocations. The JKTN is designed to list patients needing kidney transplants on the computer according to the following policies; 1) the same ABO blood type 2) the quality of the HLA match (the number of matches between the recipient's antigens and the donor's antigen) 3) the waiting time (the time since entry) If a perfect HLA match (6 matches) recipient is listed on the computer, the kidney shoud be transported to the patient nationwide. When it is certain that the recipient hospital will use the kidney according to the negative data of the final direct lymphocyte cros smatch, the JKTN can decide to transport the graft to the recipient hospital. About 350 kidney grafts were transplanted through the new system is the last two years and the policies of graft allocation should be reevaluted based on the results of graft survival. |
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