There are more than 2,700 people waiting for organ donation in Hong Kong, and 85% of them are waiting for a kidney transplant.
The Hospital Authority launched the "Kidney Matching Donation Pilot Program" at the end of 2018, for those who intend to donate their kidneys to their family members but whose physical condition does not match, cross-match donations with another family.
Three years later, good news came. Two patients who had undergone dialysis for nearly 6 to 8 years were successfully transplanted.
The family members who donated the kidneys admitted that their heartache, the other half endured the constraints of kidney dialysis and the risk and pain of complications. "After getting married, I have decided to donate the kidney." I have a chance to be born again.” The Hospital Authority is also actively considering extending the matching program to the liver and even overseas matching banks.
The HA's Kidney Matching Donation Pilot Project was successfully matched for the first time.
(Photo by Luo Junhao)
Both kidneys and livers can be transplanted in vivo, and patients who need kidney transplants account for the most. As of the end of June this year, there were 2,320 people, and the average waiting time for cadaveric kidneys was 4 and a half years.
In addition to cadaveric kidney transplantation, the patient can also receive a living kidney, but it cannot be done when the blood type and HLA antibody of the family members who are willing to donate do not match.
The HA launched a pilot kidney matching program at the end of 2018, allowing patients and a family member to join the matching library and pair them with another family for "cross donation".
Since both parties cannot know the identity of each other, the identities of the two families cannot be disclosed.
Among them, the recipient patient had a dialysis for 8 years. Three years ago, he learned that there was a matching plan to immediately join the matching library. Last year, he learned that he had successfully matched with another family, but the other party withdrew his intention 2 to 3 weeks before the operation.
However, good news came in June of this year. They can be matched with patient B and their family members. Finally, the operation will be completed at the end of August this year, the hospital will be discharged at the beginning of September, and the Mid-Autumn Festival will be reunited.
The family of Patient A said that they had hoped to donate kidneys to their family many years ago. Unfortunately, the blood type was not suitable for the end. They had to wait for the corpse kidneys all the time. It’s so uncomfortable.” Patient A who received the donation bluntly said that he had been suffering from dialysis for many years, “If there is no such plan, I really don’t know how long it takes to have a chance to have a kidney transplant.....Special thanks to my significant other for participating in this plan. , Donating a kidney selflessly has a chance of rebirth than me.”
The surgical team is undergoing a kidney transplant for one of the patients.
(Photo provided by the Hospital Authority)
For many years, the family of patient B has also been distressed that the other half has endured the dialysis constraints and the risk of complications. "After marriage, I have decided to donate a kidney, and I have no doubt about it", but the blood type does not match. This year, I learned that there is a cross-donation plan and immediately joined it. Complete the operation.
When patient B learns that his family members have different blood types, he has no hope for a kidney transplant, but rekindles hope after knowing that they can be matched.
The two sets of kidney transplants were performed at Mary and Princess Margaret Hospitals. In order to prevent the two families from knowing the identity of each other, the hospital also had to keep secrets.
The head of Urology Department of Princess Margaret Hospital and the consultant doctor of the Department of Surgery, Lin Yiu-chung, said that regardless of admission, before and after the operation, hospitalization and discharge, the two families should be avoided and the two groups of operations should be fair. Therefore, the two hospitals should "match the table." , Simultaneously perform anesthesia, drop the knife, and minimally invasive kidney extraction through visual methods.
Mai Zhaojia said that donors must cross the psychological barrier to donate kidneys to people who have never met before.
(Photo by Luo Junhao)
Although the recipients of this surgery had complications, they were all properly handled and discharged from the hospital. Mai Zhaojia, chairman of the Central Nephrology Committee of the Hospital Authority, said that the two families had completed blood type and HLA antibody tests beforehand, which did not increase the risk of rejection.
Ma Jinwen, co-director of dialysis and transplantation services at the Department of Comprehensive Nephrology at Queen Mary Hospital, added that the longer the kidney is from the body is ischemia, the longer the recovery time for the recipient will be. The operation time can be properly arranged when the living body is donated. The kidney will be transplanted after ischemia in about 10 to 30 minutes. To the recipient's body, it is faster than the body donation.
As for how to choose a matching library, Guo Shaoyan, co-chair of the HA Kidney Matching Donation Project Working Group, said that matching will be done every three months, and the age difference between the two groups of family members should not exceed 30 years. The first consideration is that their blood types and HLA antibodies match. After that, age and waiting time in the matching library will also be considered.
Guo Shaoyan said that the first condition for cross donation is that the blood types and HLA antibodies of both parties match.
(Photo by Luo Junhao)
There are currently 26 pairs of families in the matching library. Feng Jiaxin, chairman of the Working Group of the Hospital Authority Kidney Matching Donation Project, said that there are indeed fewer at the beginning of its establishment, and it is expected that there will be 50 to 100 pairs in a few years.
Mai Zhaojia said that the psychological barrier of the recipient’s family is not easy to cross, because the target of donation is no longer family members, but strangers who have never met, but most people who are suitable to join the matching library are willing to consider.
Li Liye, Chief Administrative Manager (Integrated Clinical Services) of the Hospital Authority, said that the first successful matching representative plan is feasible, and he hopes that the public will have confidence in the plan and more people will be willing to join the matching library.
He also mentioned that the authorities will actively consider extending the matching plan to the liver and overseas matching banks, but they will have to face legal and organ transportation challenges.
Li Liye hopes that the public will have confidence in the plan and expand the matching database.
(Photo by Luo Junhao)
Participants need to pass three hurdles
1. The patient is to be diagnosed as needing a kidney transplant and has been included in the organ waiting list
2. The immediate family member or spouse intends to donate their own organs, and the inspection proves that they are not suitable for donation to their family members
3. The two-person group voluntarily participates in the Kidney Matching Donation Pilot Program, and will be included in the matching pool. Blood samples will be taken for testing and paired with other groups in the pool.
In the early years of the Hospital Authority, for example, if the three sons of a female patient wanted to donate kidneys to her, but they were clinically assessed as unsuitable, and all three of them were interested in participating in the pilot project, three combinations would be put into the matching pool, namely, "Mom and "Elder Son", "Mom and Second Son" and "Mom and Third Son"
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