Data and optimisation requirements for Kidney Exchange Programs

Abstract

Kidney Exchange Programs (KEP) are valuable tools to increase the options of living donor kidney transplantation for patients with end-stage kidney disease with an immunologically incompatible live donor. Maximising the benefits of a KEP requires an information system to manage data and to optimise transplants. The data input specifications of the systems that relate to key information on blood group and Human Leukocyte Antigen (HLA) types and HLA antibodies are crucial in order to maximise the number of identified matched pairs while minimising the risk of match failures due to unanticipated positive crossmatches. Based on a survey of eight national and one transnational kidney exchange program, we discuss data requirements for running a KEP. We note large variations in the data recorded by different KEPs, reflecting varying medical practices. Furthermore, we describe how the information system supports decision making throughout these kidney exchange programs.

Scandiatransplant Exchange Program (STEP): Development and Results From an International Kidney Exchange Program

“…10 Currently, there are 4 established transnational KEPs: Australian and New Zealand Paired Kidney Exchange (Australia and New Zealand), CAI (Czech Republic, Austria, and Israel), KEP South Transplant Alliance (Spain, Italy, and Portugal), and STEP. 8 Some of the key features of these 4 multinational programs are listed in Table 3. An important difference between transnational KEPs is whether they have a merged or sequential patient-donor pool.…”

“…Currently, there are 4 established transnational KEPs: Australian and New Zealand Paired Kidney Exchange (Australia and New Zealand), CAI (Czech Republic, Austria, and Israel), KEP South Transplant Alliance (Spain, Italy, and Portugal), and STEP. 8 …”

“…The collected data are similar to what has been described as the common core of information that needs to be collected in a KEP to make relevant assessments. 8 At present, match runs are conducted 3 to 4 times per year, followed by reruns when broken cycles are identified early. A steering committee was established with representatives from each country, including experts in data management, organ allocation, matching theory, immunology, transplant surgery, and nephrology.…”

“…The collected data are similar to what has been described as the common core of information that needs to be collected in a KEP to make relevant assessments. 8 …”