Ten kidney paired donation transplantation on World Kidney Day 2013: raising awareness and time to take action to increase donor pool

Kute, Vivek B.; Vanikar, Aruna V; Shah, Pankaj; Gumber, Manoj R.; Patel, Himanshu V.; Modi, Pranjal; Rizvi, Syed Jamal; Shah, Veena R; Modi, Manisha P; Kanodia, Kamal V; Trivedi, Hargovind L

doi:10.3109/0886022x.2013.823997

Cited by 12 publications

(21 citation statements)

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“…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 .…”

Section: Discussionmentioning

confidence: 91%

“…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 .…”

Section: Introductionmentioning

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: Discussionmentioning

confidence: 91%

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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“…The limitation is not a willingness to participate in KPD, but rather barriers to execution. 26 Allocation of donor kidneys on the basis of HLA compatibility increases graft survival, 15-18 but prolongs the wait for a kidney in patients who have HLA phenotypes that are not common in the donor population. 18 In this modern era of immunosuppression, better HLA matching is associated not only with better graft survival, but also with the administration of lower dosages of immunosuppressive agents, a lower incidence of side-effects of immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Successful three-way kidney paired donation with compatible pairs to increase donor pool

et al. 2013

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Despite heightened international interest in performing living donor kidney paired donation (KPD) transplantation after the publication of a research protocol by Ross and colleagues in 1997, only a few hundred have been performed worldwide. The major obstacle is that many individuals in end-stage renal disease are of blood type O and can only receive an organ from a donor of blood type O, whereas blood type O donors are "universal donors" and will be able to donate directly with an intended recipient of any blood type unless there is a positive crossmatch. To overcome this, patients with compatible but non-HLA identical donors over 45 years of age should be approached for inclusion in KPD program especially O blood group donors. Inclusion of all these additional pairs into the algorithm greatly increases chances of possible matches for O blood group recipients. We report successful three-way KPD transplantation resulting in transplantation of O blood group patient using compatible O blood group donor from India. None of the patients had delayed graft function or rejection and all had stable graft function on discharge without any medical and surgical complications. We need to allocate O blood group kidneys from compatible donors to overcome the barrier of HLA, non-HLA antibodies and other donor related factors to improve transplant quality and long term outcomes. This will increase transplantation of O blood group patients.

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“…We have performed 27 patients in 3 way simultaneous KPD transplants as DRP were not willing for the non-simultaneous KT and this will also avoid the risk of donor reneging. However, from our previous experience of 10 KPD transplants (5 pairs of 2-way exchanges) in our single center in single day (on world kidney day 2013); our surgical team proposed that simultaneous KT of more than five-way exchange in KPD transplants is very difficult to perform logistically in our single center[6]. In addition, patients developed infections leading to break in simultaneous KT twice.…”

Section: Discussionmentioning

confidence: 99%

“…Our center in Ahmedabad, India has pioneered kidney paired donation (KPD) transplantation over the last 10 years[2-6]. Two way single center KPD has the inherent limitation to increase transplant rate[2-4].…”

Section: Introductionmentioning

confidence: 99%

Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India

Kute¹,

Patel²,

Varyani³

et al. 2016

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AIMTo avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression.METHODSWe present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility (n = 1); positive cross-match and/or presence of donor specific antibody (n = 5). The average time required from registration in kidney paired donation (KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo.RESULTSGraft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection (Banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo follow-up. The waiting time in KPD was short as compared to deceased donor KT.CONCLUSIONWe report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.

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Ten kidney paired donation transplantation on World Kidney Day 2013: raising awareness and time to take action to increase donor pool

Abstract: This is a report of 10 simultaneous KPD transplantations in a single day in a single centre on WKD raising awareness of KPD. KPD is viable, legal and rapidly growing modality for facilitating LRDRTx for patients who are incompatible with their healthy, willing LRD.

Cited by 12 publications

References 20 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

Successful three-way kidney paired donation with compatible pairs to increase donor pool

Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India

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