International Cooperation for Kidney Exchange Success

Valentín, María O.; García, Mercé; Costa, Alessandro Nanni; Bolotinha, Catarina; Guirado, Lluís; Vistoli, Fabio; Breda, Alberto; Fiaschetti, P.; Domínguez‐Gil, Beatriz

doi:10.1097/tp.0000000000002664

Cited by 16 publications

(7 citation statements)

References 4 publications

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“…Outros relatos de doação internacional têm surgido, envolvendo programas do mundo inteiro. [9][10][11][12] Os EUA e o Canadá relataram uma troca em dominó que começou com um doador falecido, tendo sido implementada entre setembro de 2009 e agosto de 2010. 9 Na Ásia, especificamente na Índia, o primeiro Transplante renal cruzado internacional foi relatado em 2018, envolvendo um par indiano e um par português, embora o paciente português não estivesse registrado na lista de espera portuguesa.…”

Section: Discussionunclassified

“…11 Desde então, foram criados outros programas internacionais, incluindo o SAT, que registrou o seu primeiro resultado em julho de 2018, após a realização do primeiro cruzamento em maio de 2018, que consistiu num intercâmbio bidirecional entre Espanha e Itália. 12 As vantagens de programas como estes têm sido amplamente discutidas, com particular destaque para o aumento do número de doadores disponíveis, o que melhora a probabilidade de encontrar um par através do aumento da diversidade genética -um fator particularmente importante para os pacientes sensibilizados. Além disso, esses programas aumentam a probabilidade de uma melhor compatibilidade entre os pares, resultando em maior compatibilidade HLA e reduzindo potencialmente a incidência de episódios de rejeição.…”

Section: Discussionunclassified

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Doação Renal Cruzada Internacional – A Experiência de um Único Centro

Francisco,

Carvalho,

Freitas

et al. 2023

BJT

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Introdução: O transplante renal é o tratamento preferencial da doença renal crônica terminal, porém, a escassez de órgãos pode resultar em longos tempos de espera. O transplante renal de doador vivo oferece uma alternativa ao doador cadáver, mas a incompatibilidade HLA ou AB0 pode representar um obstáculo significativo. Este estudo teve como objetivo mostrar os resultados alcançados por um hospital português desde sua integração num programa internacional de doação cruzada, o South Alliance for Transplants (SAT). Métodos: O programa SAT foi fundado em 2017 e é composto por dez hospitais espanhóis, três hospitais italianos e um hospital português. O programa ocorre a cada 4 meses e inscreve apenas pares que são incompatíveis. O transporte de órgãos é realizado em parceria com a Força Aérea Portuguesa. Resultados: Foram realizados três cruzamentos distintos em parceria com três hospitais espanhóis, culminando no transplante de três doentes portugueses de um total de sete doentes. O primeiro cruzamento foi realizado em março de 2020, no início da pandemia de COVID-19, com a parceria de dois hospitais portugueses e um hospital espanhol, envolvendo 1 par doador/recetor de cada país, em que o português apresentava incompatibilidade AB0 e onde não se registraram complicações. O segundo ocorreu em dezembro de 2021 com 3 pares doador/receptor (1 português em que o recetor apresentava anticorpos anti-dador e crossmatch positivo com o potencial doador; e 2 de dois hospitais espanhóis), complicado com rejeição celular tipo-IB uma semana após o transplante no receptor português, tratada com corticoterapia. O terceiro cruzamento ocorreu também em dezembro de 2021 com 2 pares doador/recetor (1 português e 1 espanhol), complicado com atraso na função renal por necrose tubular aguda (diagnóstico histológico) na receptora portuguesa. Durante o follow-up, os níveis de creatinina sérica dos doentes mantiveram-se dentro dos limites normais, e não foram registradas outras intercorrências. Conclusão: O programa SAT permitiu a realização de alguns transplantes renais cruzados bem-sucedidos, provavelmente melhorando os resultados do transplante renal em Portugal. A expansão de programas semelhantes pode contribuir para um uso mais eficiente dos recursos disponíveis, aumentando o número de transplantes realizados e reduzindo os tempos de espera.

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Section: Discussionunclassified

Doação Renal Cruzada Internacional – A Experiência de um Único Centro

Francisco,

Carvalho,

Freitas

et al. 2023

BJT

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“…Other reports of international donation have emerged, involving programs from around the world. [9][10][11][12] The USA and Canada reported a domino exchange that began with a deceased donor and was implemented between September 2009 and August 2010. 9 In Asia, specifically in India, the first international KPD was reported in 2018, involving an Indian pair and a Portuguese pair, although the Portuguese patient was not registered on the Portuguese waiting list.…”

Section: Discussionmentioning

confidence: 99%

“…11 Since then, other international programs have been created, including the SAT, which recorded its first result in July 2018 after the first matching run was conducted in May 2018, which was a 2-way exchange between Spain and Italy. 12 The advantages of programs like these have been discussed extensively, with a particular emphasis on the increased number of available donors, which improves the likelihood of finding a match by increasing genetic diversity -a factor that is particularly important for sensitized patients. Additionally, these programs increase the likelihood of a better match between pairs, resulting in greater HLA compatibility and potentially reducing the incidence of rejection episodes.…”

Section: Discussionmentioning

confidence: 99%

International Kidney Paired Donation – The Experience of a Single Center

Francisco,

Carvalho,

Freitas

et al. 2023

BJT

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Introduction: Kidney transplantation is the preferred treatment for end-stage renal disease, but organ scarcity can result in long waiting times. Living-donor kidney transplantation offers an alternative to deceased donation, but HLA or AB0 incompatibility can pose a significant obstacle. This study aimed to show the results achieved by a portuguese hospital since its integration into an international cross-over program, the South Alliance for Transplants (SAT). Methods: The SAT program was founded in 2017 and is composed of ten Spanish hospitals, three Italian hospitals and one Portuguese hospital. The program runs every 4 months and enrolled only pairs that were incompatible. Organ transportation is carried out in partnership with the Portuguese Air Force. Results: Three distinct cross-over kidney transplants were performed in partnership with three Spanish hospitals, culminating in the transplantation of three Portuguese patients out of a total of seven patients. The first swap was performed in March 2020, at the beginning of the COVID-19 pandemic, in partnership with two Portuguese and one Spanish hospital. It involved one donor/recipient pair from each country, with AB0 incompatibility between the Portuguese donor and recipient, and no complications were reported. The second swap occurred in December 2021, with three donor/recipient pairs (one Portuguese, where the recipient presented anti-donor antibodies and positive crossmatch with the potential donor, and two from two Spanish hospitals). It was complicated by type-IB cellular rejection in the Portuguese recipient, one week after transplantation, which was treated with corticosteroid therapy. The third swap, also in December 2021, involved two donor/recipient pairs (one Portuguese and one Spanish). It was complicated by delayed renal function due to acute tubular necrosis (histological diagnosis) in the Portuguese recipient. At follow-up, the patients‘ serum creatinine levels were within normal limits, and no other unexpected outcomes were recorded. Conclusion: SAT program has allowed some successful cross-over kidney transplants, probably improving the outcomes of kidney transplantation in Portugal. The expansion of such programs may contribute to a more efficient use of the available resources, increasing the number of transplants performed and reducing waiting times

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“…Chains initiated by deceased donors 21,22 increase the interaction between deceased and kidney exchange systems. Furthermore, with increasing transnational collaboration on KEPs, 23,24 the above-mentioned concerns should also be considered and addressed. It is possible to enter some data (such as HLA typing) directly from diagnostic equipment, and if such features are available it is important to verify that the equipment and the database can communicate.…”

Section: Interactions With Other Systemsmentioning

confidence: 99%

Data and optimisation requirements for Kidney Exchange Programs

Smeulders

Pettersson

Viana

et al. 2021

Health Informatics J

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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.

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International Cooperation for Kidney Exchange Success

Cited by 16 publications

References 4 publications

Doação Renal Cruzada Internacional – A Experiência de um Único Centro

Doação Renal Cruzada Internacional – A Experiência de um Único Centro

International Kidney Paired Donation – The Experience of a Single Center

Data and optimisation requirements for Kidney Exchange Programs

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