Open AccessThe 6‐year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program ‐ a retrospective study
Author(s) -
Stepkowski Stanislaw M.,
Mierzejewska Beata,
Fumo David,
Bekbolsynov Dulat,
Khuder Sadik,
Baum Caitlin E.,
Brunner Robert J.,
Kopke Jonathan E.,
Rees Susan E.,
Smith Connie,
Ashlagi Itai,
Roth Alvin E.,
Rees Michael A.
Publication year - 2019
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13423
Subject(s) - medicine , donation , organ procurement , transplantation , retrospective cohort study , organ donation , kidney transplantation , prioritization , united network for organ sharing , surgery , liver transplantation , management science , economics , economic growth
Summary We examined what happened during a 6‐year period to 1121 end‐stage renal disease patients who registered with their willing/incompatible living donors for kidney exchanges with the Alliance for Paired Donation ( APD ). Of all patients, 65% were transplanted: 37% in kidney paired donation ( APD ‐ KPD , APD ‐other‐ KPD ); 10% with compatible live donors ( APD ‐ LD ); and 18% with deceased donors ( APD ‐ DD ). The remaining patients were withdrawn (sick/died/others; 15%), or were still waiting (20%). For those patients with a cPRA 0–94%, 72% received a transplant. In contrast, only 49% of very highly sensitized ( VHS ; cPRA 95–100%) were transplanted. Of the VHS patients, 50% were transplanted by KPD / APD ‐ LD while 50% benefited through prioritization of deceased donors in the modified kidney allocation system ( KAS introduced in 2014). All APD transplanted groups had similar death‐censored 4‐year graft survivals as their relevant Organ Procurement and Transplantation Network ( OPTN ) groups. It is noteworthy that VHS graft and patient survival results were comparable to less sensitized and nonsensitized patients. All patients should be encouraged to search for compatible donors through different options. Expanding the donor pool through KPD and the new KAS of the OPTN increases the likelihood of transplantation for VHS patients.