Four years of experience with the <scp>A</scp>ustralian kidney paired donation programme

Cantwell, Linda; Woodroffe, Claudia; Holdsworth, Rhonda; Ferrari, Paolo

doi:10.1111/nep.12369

Cited by 31 publications

(27 citation statements)

References 39 publications

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“…Our centre in Ahmedabad, India, has pioneered KPD transplantation over the last few years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. KPD has increased access to LDKT in national [17][18][19][20][21][22][23][24] and single-centre programmes across the world [1,2,8,24].…”

Section: Kidney Transplantation Scenario In Indiamentioning

confidence: 99%

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Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

et al. 2017

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In a living donor kidney transplantation (LDKT) dominated transplant programme, kidney paired donation (KPD) may be a cost-effective and valid alternative strategy to increase LDKT in countries with limited resources where deceased donation kidney transplantation (DDKT) is in the initial stages. Here, we report our experience of 300 single-centre KPD transplantations to increase LDKT in India. Between January 2000 and July 2016, 3616 LDKT and 561 DDKT were performed at our transplantation centre, 300 (8.3%) using KPD. The reasons for joining KPD among transplanted patients were ABO incompatibility (n = 222), positive cross-match (n = 59) and better matching (n = 19). A total of 124 two-way (n = 248), 14 three-way (n = 42), one four-way (n = 4) and one six-way exchange (n = 6) yielded 300 KPD transplants. Death-censored graft and patient survival were 96% (n = 288) and 83.3% (n = 250), respectively. The mean serum creatinine was 1.3 mg/dl at a follow-up of 3 ± 3 years. We credit the success of our KPD programme to maintaining a registry of incompatible pairs, counselling on KPD, a high-volume LDKT programme and teamwork. KPD is legal, cost effective and rapidly growing for facilitating LDKT with incompatible donors. This study provides large-scale evidence for the expansion of single-centre LDKT via KPD when national programmes do not exist.

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Section: Kidney Transplantation Scenario In Indiamentioning

confidence: 99%

“…Our centre in Ahmedabad, India, has pioneered KPD transplantation over the last few years . KPD has increased access to LDKT in national and single‐centre programmes across the world .…”

Section: Introductionmentioning

confidence: 99%

Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

et al. 2017

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“…[1][2][3][4][5][6][7] In the United States alone there have been over 2000 nondirected kidney donors (NDDs) and the numbers are steadily increasing. [1][2][3][4][5][6][7] In the United States alone there have been over 2000 nondirected kidney donors (NDDs) and the numbers are steadily increasing.…”

Section: Introductionmentioning

confidence: 99%

“…Nondirected kidney donation-involving individuals donating a kidney to someone completely unknown to them and who is on the waiting list-has become acceptable in many countries. [1][2][3][4][5][6][7] In the United States alone there have been over 2000 nondirected kidney donors (NDDs) and the numbers are steadily increasing. 8 When NDD programs were first developed, the NDD donated to a recipient on the list at the center where the donor underwent evaluation.…”

Section: Introductionmentioning

confidence: 99%

Long-term psychosocial outcomes after nondirected donation: A single-center experience

Jacobs

Berglund

Wiseman

et al. 2019

American Journal of Transplantation

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Short‐term studies have demonstrated that nondirected donors (NDDs) have psychosocial outcomes that are similar to donors who donate directly, but long‐term studies have not been done. NDDs at our center were surveyed regarding motivation; support during donation; stress related to donation; regret; financial resources used for donation; preferences about communication with the recipient; and cost reimbursement. Of 100 NDDs who donated at our center in the last 20 years, 95 remain in contact with us, and 77 responded to our survey (mean ± standard deviation [SD] 6.7 ± 4 years postdonation). The most common motivation for donation was the desire to help another (99%). Many NDDs received support from family, friends, and employers. NDDs voiced stress about the possibility of recipient kidney rejection, physical consequences to themselves, and financial burden. Only one donor expressed regret. Almost half wanted some recipient information at donation; 61% preferred routine recipient status updates; 56% believed meeting the recipient should occur at any mutually agreeable time; and 55% endorsed reimbursement for expenses. Stressors for NDDs are analogous to those of directed donors; NDDs prefer having some information about the recipient and prefer to be given a choice regarding the timing for communication with the recipient. NDDs supported donation being financially neutral.

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“…States and other parts of the world. 7,[21][22][23][24] In addition, as recently reported in depth, the shipping of kidneys during paired exchange has not been associated with inferior transplant outcomes. 25 Although the number with primary nonfunction (0.34%) was low, the number with first week dialysis (4.9%) is higher than in-center exchanges.…”

Section: Yearmentioning

confidence: 59%

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

Flechner

Thomas

Ronin

et al. 2018

American Journal of Transplantation

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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.

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Four years of experience with the Australian kidney paired donation programme

Cited by 31 publications

References 39 publications

Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

Long-term psychosocial outcomes after nondirected donation: A single-center experience

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

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