Successful three-way kidney paired donation transplantation: The first Indian report

Abstract

Providing transplantation opportunities for patients with incompatible live donors through kidney paired donation (KPD) is an important strategy for easing the crisis in organ availability. KPD is can overcome the barriers when the only living potential donors are deemed unsuitable owing to an incompatibility of blood type, of human leukocyte antigen cross-match, or both. In KPD, the incompatibility problems with two donor recipient pairs can be solved by exchanging donors. In the absence of well-organized deceased donor program, or transplantation with desensitization protocol and ABO incompatible transplantation, living donor KPD promises hope to the growing number of patients suffering from end-stage renal disease in India. We report our first successful three-way KPD transplantation from India. In an era of organ shortage, this approach is relevant to encourage wider participation from KPD donors and transplant centers to prevent commercial transplantation.

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

“…Internet‐based communication tools should be used to connect with other incompatible pairs . Our report showed that different KPD forms (Table ) can be successfully applied in any country with limited resources .…”

“…A large‐volume transplant centre can employ a single‐centre KPD programme when national programmes do not exist. A single‐centre KPD programme is easy and less costly than the national KPD programme ; it avoids challenges for the travelling donor due to variability between donor work up and donor surgery and eliminates potential barriers in multicentre programmes, such as donor travel, shipping of kidney, follow‐up care and disparity in healthcare cost and quality. Smaller centres should initially focus on easy‐to‐match pairs and employ multicentre KPD programmes to reduce waiting time and improve the quality and quantity of matches.…”

“…KPD is underutilized in India due to the lack of a KPD registry in the national programme; a lack of single‐centre KPD practice; a lack of harmony and coordination among different transplant units; variable healthcare costs and quality; a lack of uniform evaluation and follow‐up care for transplant patients and donors; inefficient matching algorithms; and legal, regulatory, logistical and economic barriers. 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 .…”

Increasing access to renal transplantation in India through our single-center kidney paired donation program: a model for the developing world to prevent commercial transplantation

“…The match runs are performed manually without computer software. Allocation rules are mentioned in Table 1 [6][7][8][9][10][11][12][13][14][15][16]. All recipients had anatomic, functional and immunological similar and suitable donors, and they were allowed to meet each other before and after RT.…”

Kidney-paired donation to increase living donor kidney transplantation in India: Guidelines of Indian Society of Organ Transplantation – 2017

“…In India, in the absence of national KPD program, only single-center KPD is practiced. [ 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ] Table 2 shows the key elements of success of single-center KPD program at the Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India, a center which has performed 300 KPD transplants in India. [ 2 3 4 5 6 7 8 9 10 ]…”