Characteristics of Compatible Pair Participants in Kidney Paired Donation at a Single Center

Overview

Journal Clin Transplant

Specialty General Surgery

Date 2017 Mar 26

PMID 28342273

Citations 6

Authors

Francis L Weng

Tracy Grogan

Anup M Patel

Shamkant Mulgaonkar

Marie M Morgievich

Affiliations

Soon will be listed here.

Abstract

Compatible pairs of living kidney donors and their intended recipients can enter into kidney paired donation (KPD) and facilitate additional living donor kidney transplants (LDKTs). We examined 11 compatible pairs (the intended recipients and their intended, compatible donors) who participated in KPD, along with the recipients' 11 matched, exchange donors. The 11 pairs participated in 10 separate exchanges (three were multicenter exchanges) that included 33 total LDKTs (22 additional LDKTs). All the intended donors were blood group O and female, with a mean living kidney donor profile index (LKDPI) of 27.6 (SD 16.8). The matched donors had a mean LKDPI of 9.4 (SD 31.7). Compatible pairs entered KPD for altruistic reasons (N=2) or due to mismatch of age (N=7) or body/kidney size (N=2) between the recipient and intended donor. In four cases, retrospective calculation of the LKDPI revealed that the matched donor had a higher LKDPI than the intended donor. Of the 22 recipients of LDKTs enabled by the compatible pairs, three were highly sensitized, with PRA >80%. In conclusion, most compatible pairs entered into KPD so that the recipient could receive a LDKT transplant from a donor whose age or body/kidney size were more favorable to post-transplant outcomes.

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References

Massie A, Leanza J, Fahmy L, Chow E, Desai N, Luo X . A Risk Index for Living Donor Kidney Transplantation. Am J Transplant. 2016; 16(7):2077-84. PMC: 6114098. DOI: 10.1111/ajt.13709. View

Ratner L, Ratner E, Kelly J, Carrol M, Cherwinski K, Ernst V . Altruistic unbalanced paired kidney exchange at Columbia University/New York-Presbyterian hospital: rationale and practical considerations. Clin Transpl. 2009; :107-12. View

Bingaman A, Wright Jr F, Kapturczak M, Shen L, Vick S, Murphey C . Single-center kidney paired donation: the Methodist San Antonio experience. Am J Transplant. 2012; 12(8):2125-32. DOI: 10.1111/j.1600-6143.2012.04070.x. View

Montgomery R, Zachary A, Ratner L, Segev D, Hiller J, Houp J . Clinical results from transplanting incompatible live kidney donor/recipient pairs using kidney paired donation. JAMA. 2005; 294(13):1655-63. DOI: 10.1001/jama.294.13.1655. View

Fortin M . Is it ethical to invite compatible pairs to participate in exchange programmes?. J Med Ethics. 2013; 39(12):743-7. DOI: 10.1136/medethics-2012-101129. View

Ross L, Woodle E . Ethical issues in increasing living kidney donations by expanding kidney paired exchange programs. Transplantation. 2000; 69(8):1539-43. DOI: 10.1097/00007890-200004270-00001. View

Veatch R . Organ exchanges: fairness to the O-blood group. Am J Transplant. 2006; 6(1):1-2. DOI: 10.1111/j.1600-6143.2005.01164.x. View

Schold J, Kaplan B . Living Kidney Donor Profile Index: Utility and Limitations. Am J Transplant. 2016; 16(7):1951-2. DOI: 10.1111/ajt.13727. View

Ratner L, Rana A, Ratner E, Ernst V, Kelly J, Kornfeld D . The altruistic unbalanced paired kidney exchange: proof of concept and survey of potential donor and recipient attitudes. Transplantation. 2010; 89(1):15-22. DOI: 10.1097/TP.0b013e3181c626e1. View

10.

Orandi B, Luo X, Massie A, Garonzik-Wang J, Lonze B, Ahmed R . Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors. N Engl J Med. 2016; 374(10):940-50. PMC: 4841939. DOI: 10.1056/NEJMoa1508380. View

11.

Parker W, Thistlethwaite Jr J, Friedman Ross L . Kidney Donor Profile Index Does Not Accurately Predict the Graft Survival of Pediatric Deceased Donor Kidneys. Transplantation. 2016; 100(11):2471-2478. PMC: 4940335. DOI: 10.1097/TP.0000000000001028. View

12.

Cuffy M, Ratner L, Siegler M, Woodle E . Equipoise: ethical, scientific, and clinical trial design considerations for compatible pair participation in kidney exchange programs. Am J Transplant. 2015; 15(6):1484-9. DOI: 10.1111/ajt.13218. View

13.

Montgomery R, Lonze B, King K, Kraus E, Kucirka L, Locke J . Desensitization in HLA-incompatible kidney recipients and survival. N Engl J Med. 2011; 365(4):318-26. DOI: 10.1056/NEJMoa1012376. View

14.

Kute V, Vanikar A, Gumber M, Shah P, Patel H, Engineer D . Successful three-way kidney paired donation with compatible pairs to increase donor pool. Ren Fail. 2013; 36(3):447-50. DOI: 10.3109/0886022X.2013.868294. View

15.

Gentry S, Segev D, Simmerling M, Montgomery R . Expanding kidney paired donation through participation by compatible pairs. Am J Transplant. 2007; 7(10):2361-70. DOI: 10.1111/j.1600-6143.2007.01935.x. View

16.

Ferrari P, Cantwell L, Ta J, Woodroffe C, DOrsogna L, Holdsworth R . Providing Better-Matched Donors for HLA Mismatched Compatible Pairs Through Kidney Paired Donation. Transplantation. 2016; 101(3):642-648. DOI: 10.1097/TP.0000000000001196. View

17.

Kacar S, Eroglu A, Tilif S, Guven B, Okcuoglu Kadioglu Z . A novel experience in living donor renal transplantation: voluntary exchange kidney transplantation. Transplant Proc. 2013; 45(6):2106-10. DOI: 10.1016/j.transproceed.2012.10.032. View

18.

Milner J, Melcher M, Lee B, Veale J, Ronin M, DAlessandro T . HLA Matching Trumps Donor Age: Donor-Recipient Pairing Characteristics That Impact Long-Term Success in Living Donor Kidney Transplantation in the Era of Paired Kidney Exchange. Transplant Direct. 2016; 2(7):e85. PMC: 5087568. DOI: 10.1097/TXD.0000000000000597. View

19.

Segev D, Gentry S, Melancon J, Montgomery R . Characterization of waiting times in a simulation of kidney paired donation. Am J Transplant. 2005; 5(10):2448-55. DOI: 10.1111/j.1600-6143.2005.01048.x. View

20.

Levey A, Stevens L, Schmid C, Zhang Y, Castro 3rd A, Feldman H . A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150(9):604-12. PMC: 2763564. DOI: 10.7326/0003-4819-150-9-200905050-00006. View