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Living donor kidney paired donation transplantation: experience as a founding member center of the N ational K idney R egistry
Author(s) -
Leeser David B.,
Aull Meredith J.,
Afaneh Cheguevara,
Dadhania Darshana,
Charlton Marian,
Walker Jennifer K.,
Hartono Choli,
Serur David,
Del Pizzo Joseph J.,
Kapur Sandip
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01606.x
Subject(s) - medicine , transplantation , donation , economic shortage , demographics , kidney transplantation , single center , surgery , demography , linguistics , philosophy , government (linguistics) , sociology , economics , economic growth
Kidney paired donation ( KPD ) is a safe and effective means of transplantation for transplant candidates with willing but incompatible donors. We report our single‐center experience with KPD through participation in the N ational K idney R egistry. Patient demographics, transplant rates, and clinical outcomes including delayed graft function ( DGF ), rejection, and survival were analyzed. We also review strategies employed by our center to maximize living donor transplantation through KPD . We entered 44 incompatible donor/recipient pairs into KPD from 9/2007 to 1/2011, enabling 50 transplants. Incompatibility was attributable to blood type (54.4%) and donor‐specific sensitization (43.2%). Thirty‐six candidates (81.8%) were transplanted after 157 d (median), enabling pre‐emptive transplantation in eight patients. Fourteen candidates on the deceased donor waiting list also received transplants. More than 50% of kidneys were received from other transplant centers. DGF occurred in 6%; one‐yr rejection rate was 9.1%. One‐yr patient and graft survival was 98.0% and 94.8%. KPD involving participation of multiple transplant centers can provide opportunities for transplantation, with potential to expand the donor pool, minimize waiting times, and enable pre‐emptive transplantation. Our experience demonstrates promising short‐term outcomes; however, longer follow‐up is needed to assess the impact of KPD on the shortage of organs available for transplantation.