The Spanish Kidney Exchange Model: Study of Computation-Based Alternatives to the Current Procedure

Bofill, Miquel; Calderón, Marcos; Castro, Francesc; Acebo, Esteve del; Delgado, Pablo; Garcia, Marc; García, Mercé; Roig, Marc; Valentín, María O.; Villaret, Mateu

doi:10.1007/978-3-319-59758-4_31

Cited by 5 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is not expected to be associated with detrimental consequences in terms of cold ischemia injury, depending evidently on the extent of the territory involved in the program. In this first case, we selected to use the local pool of DD in order to minimize the cold ischemia time (in the reported case CIT was 5 hours), whereas the transplant from LD could be organized similarly to what happens when the chain starts with an altruistic donor (15).…”

Section: Discussionmentioning

confidence: 99%

Deceased Donor–initiated Chains: First Report of a Successful Deliberate Case and Its Ethical Implications

et al. 2019

View full text Add to dashboard Cite

Background: The utilization of deceased donor kidneys to initiate chains of living donor kidney paired donation (KPD) has been proposed, although the potential gain of this practice needs to be quantified and the ethical implications must be addressed before starting its application. Methods: The gain of implementing deceased donor-initiated chains has been measured through a mathematical algorithm, using retrospective data on the pool of donor/recipient incompatible pairs at a single Center. Allocation rules of chain ending kidneys and characteristics/quality of the chain initiating kidney (CIK) are described. Results: the quantification of benefit analysis showed that with a pool of 69 kidneys from deceased donors and 16 pairs enrolled in the KPD program, over a period of 3 years it is possible to transplant 8/16 recipients (50%). Following the approval of the Bioethical Committee of the Veneto Region and the revision of the allocation policies by the Italian National Transplant Center, the first successful case has been performed. The waiting time of the recipient (male, 53 yo) after entering the program for the CIK with a kidney donor risk index (KDRI) equal to 0.61 and a kidney donor profile index (KDPI) of 3%, was 4 days. His willing donor (female, 53 yo) with a living kidney donor profile index (LKDPI) of 2, donated 2 days later to a chain ending recipient (male, 47 yo,) who had been on dialysis for 5 years. Conclusions: This is the first report of a deliberate deceased donor-initiated chain, which has been successfully performed. This has been made possible thanks to an extensive phase of evaluation of the ethical issues and allocation policy impact. This paper includes a preliminary efficacy assessment and the development a dedicated algorithm.

show abstract

Section: Discussionmentioning

confidence: 99%