Potential of Kidney Exchange Programs (KEPs) in Japan for Donor-Specific Antibody-Positive Kidney Transplants: A Questionnaire Survey on KEPs and a Multi-Institutional Study Conducting Virtual Cross-Matching Simulations
<b>Objectives:</b> To clarify the need for a kidney exchange program (KEP) in Japan by conducting a questionnaire survey on KEPs and simulated KEPs by virtual cross-matching based on past cases of transplantation avoidance. <b>Methods:</b> In addition to the content regarding KEPs, an electronic survey was conducted to investigate the number of cases of kidney transplant abandonment due to "immunological" reasons over the past 10 years (2012-2021). Virtual cross-matching was conducted to simulate the feasibility of avoiding immunological risks and enabling kidney transplantation in patients who were previously unable to undergo the procedure. <b>Results</b>: The survey received responses from 107 facilities (response rate: 81.7%). In response to the question about the necessity of a KEP in Japan, 71 facilities (66.4%) indicated that KEPs are necessary. In addition, 251 living-donor kidney transplants were abandoned for "immunological" reasons over the past decade (2012-2021). Among the 80 pairs for which detailed information was available, virtual cross-matching simulations showed that 37/80 pairs (46.3%) were donor-specific antibody (DSA)-negative for blood type-matched combinations, and 41/80 pairs (51.3%) were DSA-negative for blood type-incompatible transplants. <b>Conclusions:</b> The need for a KEP in Japan and its potential usefulness were demonstrated.
Authors
- Daiki Iwami (ORCID: https://orcid.org/0000-0002-8274-848X)
- Masaki Muramatsu (ORCID: https://orcid.org/0000-0003-0829-9038)
- Kiyohiko Hotta (ORCID: https://orcid.org/0000-0002-8080-5962)
- Akihiro Terao
- K Nishikawa (ORCID: https://orcid.org/0000-0002-0320-977X)
- Tatsuo Yoneda
- Kohei Unagami (ORCID: https://orcid.org/0000-0001-7309-0658)
- Toshiaki Tanaka (ORCID: https://orcid.org/0000-0002-1199-9302)
- Takahiro Nohara (ORCID: https://orcid.org/0000-0001-9792-2068)
- Yoshihiko Watarai
- Chikashi Seto
- Keizo Kaku (ORCID: https://orcid.org/0000-0001-9119-1508)
- Shigeyoshi Yamanaga (ORCID: https://orcid.org/0000-0002-4372-0011)
- Kei Kurihara (ORCID: https://orcid.org/0000-0003-4970-2858)
- Satoshi Sekiguchi (ORCID: https://orcid.org/0000-0003-2066-128X)
- Masayuki Tasaki (ORCID: https://orcid.org/0000-0002-2147-4091)
- T. Ito (ORCID: https://orcid.org/0000-0001-8423-2885)
- Yuki Miyauchi
- Motoo Araki (ORCID: https://orcid.org/0000-0002-3172-2482)
- Miki Ito (ORCID: https://orcid.org/0000-0001-8617-9117)
- Kazuaki Yamanaka (ORCID: https://orcid.org/0000-0001-8581-2427)
- Mitsuru Saito (ORCID: https://orcid.org/0000-0003-1653-4309)
- Naohiro Aida (ORCID: https://orcid.org/0000-0001-9666-4730)
- Hitoshi Iwamoto
- Michio Nakamura (ORCID: https://orcid.org/0000-0002-6606-1872)
- Masayoshi Miura (ORCID: https://orcid.org/0000-0002-8469-5326)
- Daisuke Ishii (ORCID: https://orcid.org/0009-0005-2966-6476)
- Takashi Kenmochi (ORCID: https://orcid.org/0000-0002-9090-8770)
- Yasutoshi Yamada (ORCID: https://orcid.org/0000-0002-1690-8377)
- Tomonori Komatsu
- Kazuhiro Takahashi (ORCID: https://orcid.org/0000-0002-0633-9959)
- Toshihiro Asai
- Michihiro Maruyama
Institutions
- Hokkaido University of Science (JP)
- Toho University (JP)
- Tokai University (JP)
- Kyushu University (JP)
- Sapporo Medical University (JP)
- University of Tsukuba (JP)
- Jichi Medical University (JP)
- Chiba University (JP)
- Okayama University (JP)
- Mie University (JP)
- Kagawa University (JP)
- Hokkaido University (JP)
- Toyama Prefectural Central Hospital (JP)
- Tokyo Medical University Hachioji Medical Center (JP)
- Osaka City General Hospital (JP)
- Kanazawa University Hospital (JP)
- Japanese Red Cross Kumamoto Hospital (JP)
- Kitasato University Hospital (JP)
- Sapporo Hokuyu Hospital (JP)
- Nara Medical University Hospital (JP)
- Kagoshima University Hospital (JP)
- Fujita Health University Hospital (JP)
- Akita University Hospital (JP)
- Japan Community Healthcare Organization (JP)
- Kagawa University Hospital (JP)
- Tokyo Women's Medical University (JP)
- Chukyo Hospital (JP)
- Japanese Red Cross Nagoya Daini Hospital (JP)
- Ehime University (JP)
- Kitasato University (JP)
- Nara Medical University (JP)
- Niigata University (JP)
- The University of Osaka (JP)
Publication Details
- Journal
- Journal of Clinical Medicine
- Published
- 2025-08-29
- DOI
- https://doi.org/10.3390/jcm14176122
- Citations
- 1
- Primary Topic
- Renal Transplantation Outcomes and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 1.99