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

Ito, Taihei; Ito, Miki; Aida, Naohiro; Kurihara, Kei; Terao, Akihiro; Watarai, Yoshihiko; Saito, Mitsuru; Kaku, Keizo; Ishii, Daisuke; Sekiguchi, Satoshi; Yoneda, Tatsuo; Unagami, Kohei; Tasaki, Masayuki; Iwamoto, Hitoshi; Araki, Motoo; Takahashi, Kazuhiro; Yamanaka, Kazuaki; Sugimoto, Mikio; Nishikawa, Kouhei; Seto, Chikashi; Muramatsu, Masaki; Asai, Toshihiro; Iwami, Daiki; Yamada, Yasutoshi; Yamanaga, Shigeyoshi; Komatsu, Tomonori; Miura, Masayoshi; Nohara, Takahiro; Maruyama, Michihiro; Miyauchi, Yuki; Tanaka, Toshiaki; Nakamura, Michio; Hotta, Kiyohiko; Kenmochi, Takashi

doi:10.3390/jcm14176122

Permalink : https://ousar.lib.okayama-u.ac.jp/69517

ID	69517
FullText URL	fulltext.pdf 1.52 MB
Author	Ito, Taihei Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University Ito, Miki Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University Aida, Naohiro Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University Kurihara, Kei Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University Terao, Akihiro Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University Watarai, Yoshihiko Department of Transplant Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital Saito, Mitsuru Division of Blood Purification, Akita University Hospital Kaku, Keizo Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University Ishii, Daisuke Department of Urology, Kitasato University of Medicine Sekiguchi, Satoshi Transplantation Surgery, Japan Community Healthcare Organization Sendai Hospital Yoneda, Tatsuo Unit of Dialysis, Department of Urology, Nara Medical University Unagami, Kohei Organ Transplant Medicine, Tokyo Women’s Medical University Tasaki, Masayuki Division of Urology, Department of Regenerative & Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University Iwamoto, Hitoshi Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center Araki, Motoo Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap Takahashi, Kazuhiro Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery, University of Tsukuba Yamanaka, Kazuaki Department of Urology, Osaka University Graduate School of Medicine Sugimoto, Mikio Department of Urology, Faculty of Medicine, Adrenal Surgery and Renal Transplantation, Kagawa University Nishikawa, Kouhei Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine Seto, Chikashi Department of Urology, Toyama Prefectural Central Hospital Muramatsu, Masaki Department of Nephrology, Toho University Faculty of Medicine Asai, Toshihiro Department of Kidney Transplant and Dialysis, Osaka City General Hospital Iwami, Daiki Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University Yamada, Yasutoshi Department of Blood Purification, Kagoshima University Hospital Yamanaga, Shigeyoshi Department of Transplant Surgery, Japanese Red Cross Kumamoto Hospital Komatsu, Tomonori Department of Urology, Chukyo Hospital, Japan Community Healthcare Organization Miura, Masayoshi Department of Renal Transplantation Surgery and Urology, Sapporo Hokuyu Hospital Nohara, Takahiro Department of Urology, Kanazawa University Hospital Maruyama, Michihiro Department of Frontier Surgery, Chiba University School of Medicine Miyauchi, Yuki Department of Urology, Ehime University Tanaka, Toshiaki Department of Urology, Sapporo Medical University Nakamura, Michio Department of Transplant Surgery, Tokai University School of Medicine Hotta, Kiyohiko Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University Kenmochi, Takashi Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University
Abstract	Objectives: 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. Methods: 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. Results: 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. Conclusions: The need for a KEP in Japan and its potential usefulness were demonstrated.
Keywords	kidney transplantation donor-specific antibodies kidney exchange program virtual cross-matching
Published Date	2025-08-29
Publication Title	Journal of Clinical Medicine
Volume	volume14
Issue	issue17
Publisher	MDPI AG
Start Page	6122
ISSN	2077-0383
Content Type	Journal Article
language	English
OAI-PMH Set	岡山大学
Copyright Holders	© 2025 by the authors.
File Version	publisher
PubMed ID	40943882
DOI	10.3390/jcm14176122
Web of Science KeyUT	001569844000001
Related Url	isVersionOf https://doi.org/10.3390/jcm14176122
License	https://creativecommons.org/licenses/by/4.0/
Citation	Ito, T.; Ito, M.; Aida, N.; Kurihara, K.; Terao, A.; Watarai, Y.; Saito, M.; Kaku, K.; Ishii, D.; Sekiguchi, S.; et al. 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. J. Clin. Med. 2025, 14, 6122. https://doi.org/10.3390/jcm14176122
助成情報	24K11796: 本邦におけるKidney Exchange Program構築のための多施設共同研究 ( 独立行政法人日本学術振興会 / Japan Society for the Promotion of Science ) ( 一般社団法人日本臨床腎移植学会 / Japanese Society for Clinical Renal Transplantation )