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The first 9 years of kidney paired donation through the National Kidney Registry: Characteristics of donors and recipients compared with National Live Donor Transplant Registries
Author(s) -
Flechner Stuart M.,
Thomas Alvin G.,
Ronin Matthew,
Veale Jeffrey L.,
Leeser David B.,
Kapur Sandip,
Peipert John D.,
Segev Dorry L.,
Henderson Macey L.,
Shaffer Ashton A.,
Cooper Matthew,
Hil Garet,
Waterman Amy D.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14744
Subject(s) - medicine , united network for organ sharing , donation , kidney transplant , kidney transplantation , organ donation , transplantation , kidney , family medicine , economics , liver transplantation , economic growth
The practice of kidney paired donation ( KPD ) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry ( NKR ) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients ( SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR . Compared with all United Network for Organ Sharing ( UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly ( P < .001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder‐to‐match pairs.