{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:38:17Z","timestamp":1781847497061,"version":"3.54.5"},"reference-count":53,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI Grant-in-Aid for Scientific Research (C)","award":["24K11796"],"award-info":[{"award-number":["24K11796"]}]},{"name":"the Japanese Society for Clinical Renal Transplantation\u2019s Clinical Research Grant Program","award":["24K11796"],"award-info":[{"award-number":["24K11796"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u201cimmunological\u201d reasons over the past 10 years (2012\u20132021). 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 \u201cimmunological\u201d reasons over the past decade (2012\u20132021). 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.<\/jats:p>","DOI":"10.3390\/jcm14176122","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:42:21Z","timestamp":1756485741000},"page":"6122","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8423-2885","authenticated-orcid":false,"given":"Taihei","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9666-4730","authenticated-orcid":false,"given":"Naohiro","family":"Aida","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Terao","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Watarai","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Aichi 466-8650, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Saito","sequence":"additional","affiliation":[{"name":"Division of Blood Purification, Akita University Hospital, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keizo","family":"Kaku","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2966-6476","authenticated-orcid":false,"given":"Daisuke","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Urology, Kitasato University of Medicine, Kanagawa 252-0375, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Sekiguchi","sequence":"additional","affiliation":[{"name":"Transplantation Surgery, Japan Community Healthcare Organization Sendai Hospital, Miyagi 981-3281, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Unit of Dialysis, Department of Urology, Nara Medical University, Nara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Unagami","sequence":"additional","affiliation":[{"name":"Organ Transplant Medicine, Tokyo Women\u2019s Medical University, Tokyo 162-8666, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2147-4091","authenticated-orcid":false,"given":"Masayuki","family":"Tasaki","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Regenerative & Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo 193-0998, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-2482","authenticated-orcid":false,"given":"Motoo","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery, University of Tsukuba, Ibaraki 305-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikio","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Adrenal Surgery and Renal Transplantation, Kagawa University, Kagawa 761-0793, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-977X","authenticated-orcid":false,"given":"Kouhei","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikashi","family":"Seto","sequence":"additional","affiliation":[{"name":"Department of Urology, Toyama Prefectural Central Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0829-9038","authenticated-orcid":false,"given":"Masaki","family":"Muramatsu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Toho University Faculty of Medicine, Tokyo 143-8541, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplant and Dialysis, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-848X","authenticated-orcid":false,"given":"Daiki","family":"Iwami","sequence":"additional","affiliation":[{"name":"Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Tochigi 329-0498, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutoshi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Blood Purification, Kagoshima University Hospital, Kagoshima 890-8520, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeyoshi","family":"Yamanaga","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto 861-8502, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Urology, Chukyo Hospital, Japan Community Healthcare Organization, Aichi 457-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Renal Transplantation Surgery and Urology, Sapporo Hokuyu Hospital, Hokkaido 003-0006, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-2068","authenticated-orcid":false,"given":"Takahiro","family":"Nohara","sequence":"additional","affiliation":[{"name":"Department of Urology, Kanazawa University Hospital, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Frontier Surgery, Chiba University School of Medicine, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Ehime University, Ehime 791-0295, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-9302","authenticated-orcid":false,"given":"Toshiaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Urology, Sapporo Medical University, Hokkaido 060-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6606-1872","authenticated-orcid":false,"given":"Michio","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery, Tokai University School of Medicine, Kanagawa 259-1193, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8080-5962","authenticated-orcid":false,"given":"Kiyohiko","family":"Hotta","sequence":"additional","affiliation":[{"name":"Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University, Hokkaido 060-8648, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9090-8770","authenticated-orcid":false,"given":"Takashi","family":"Kenmochi","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","unstructured":"Japanese Society for Clinical Renal Transplantation and the Japan Spciety for Transplantation (2024). 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