Transporting Live Donor Kidneys for Kidney Paired Donation: Initial National Results

Segev, Dorry L.; Veale, Jeffrey L.; Berger, Judith; Hiller, Janet; Hanto, Ruthanne L.; Leeser, David B.; Geffner, Stuart; Shenoy, Surendra; Bry, W. I.; Katznelson, S.; Melcher, Marc L.; Rees, Michael; Samara, Eleftheria; Israni, Ajay K.; Cooper, Matthew; Montgomery, Robert J.; Malinzak, Lauren; Whiting, James F.; Baran, Dana; Tchervenkov, Jean; Roberts, John P.; Rogers, Jeffrey; Axelrod, David A.; Simpkins, Christopher E.; Montgomery, Robert A.

doi:10.1111/j.1600-6143.2010.03386.x

Cited by 76 publications

(65 citation statements)

References 13 publications

(18 reference statements)

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“…4 Current evidence suggests that live donor kidney transport is safe and feasible. [4][5][6] There was a remarkable lack of knowledge in the public about KPD. We believe that all the patients on maintenance dialysis should be counseled, during dialysis session, regarding the feasibility and costeffectiveness of KPD when healthy but ABO incompatible and willing donor is available.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Kidney Paired Donation Transplantations with Living Related Donor Kidney Transplantation: Implications for National Kidney Paired Donation Program

et al. 2013

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Background: Kidney Paired Donation (KPD) is a rapidly growing modality for facilitating living related donor kidney transplantation (LRDKTx) for patients who are incompatible with their healthy, willing, and living donors. Data scarcity on the outcome of KPD versus LRDKTx prompted us to review our experience. Materials and methods: This was a singlecenter study of 224 patients on regular follow-up, who underwent LRDRTx from January 2010 to June 2012 at our institute. The aim of this study was to compare short-term graft survival, patient survival and rejection rates of KPD (group 1, n ¼ 34) with those of LRDKTx (group 2, n ¼ 190). All the recipients received triple immunosuppression and thymoglobulin induction in KPD group. Kaplan-Meier curves were used for survival analysis. In group 1, mean recipient age was 35.5 AE 13.2 years, 29 were men and mean donor age was 44.4 AE 8.17 years, 10 were men. In group 2, mean recipient age was 29.1 AE 10 years, 155 were men and mean donor age was 47.5 AE 9.69 years, 74 were men. Mean human leukocyte antigen (HLA) matching in group 1 and 2 was 1 versus 3.2 (p < 0.05). Results: One-and two-year patient survival showed no significant difference between the two groups (97.1%, 97.1% vs. 96.2%, 94.8%, respectively, p ¼ 0.81). Death-censored graft survival also showed no significant difference between the two groups (97.1%, 97.1%, vs. 97.6%, 97.6%, p ¼ 0.73). Acute rejection incidence was also similar (8.7% vs. 9.9%, p > 0.62). Conclusions: Our study showed similar graft survival, patient survival and rejection rates of KPD versus LRDKTx over 2 years post-transplantation, encouraging the use of this approach for national KPD program.

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Section: Discussionmentioning

confidence: 99%

Comparison of Kidney Paired Donation Transplantations with Living Related Donor Kidney Transplantation: Implications for National Kidney Paired Donation Program

et al. 2013

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“…In this series 63% of recipients received a shipped kidney. Some of these kidneys were included in a previously published article describing the U.S. experience of shipping living donor kidneys (27). The prolonged cold ischemia time appears to have no short-term deleterious effects on the function of the shipped kidneys.…”

Section: Discussionmentioning

confidence: 99%

Chain Transplantation: Initial Experience of a Large Multicenter Program

Melcher

Leeser

Gritsch³

et al. 2012

American Journal of Transplantation

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We report the results of a large series of chain transplantations that were facilitated by a multicenter US database in which 57 centers pooled incompatible donor/recipient pairs. Chains, initiated by nondirected donors, were identified using a computer algorithm incorporating virtual cross-matches and potential to extend chains. The first 54 chains facilitated 272 kidney transplants (mean chain length = 5.0). Seven chains ended because potential donors became unavailable to donate after their recipient received a kidney; however, every recipient whose intended donor donated was transplanted. The remaining 47 chains were eventually closed by having the last donor donate to the waiting list. Of the 272 chain recipients 46% were ethnic minorities and 63% of grafts were shipped from other centers. The number of blood type O-patients receiving a transplant (n = 90) was greater than the number of blood type O-non-directed donors (n = 32) initiating chains. We have 1-year follow up on the first 100 transplants. The mean 1-year creatinine of the first 100 transplants from this series was 1.3 mg/dL. Chain transplantation enables many recipients with immunologically incompatible donors to be transplanted with high quality grafts.

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“…Immediate graft function and better allograft survival with living donor kidney transplantation could be attributed to the controlled environment at the time of procurement of a high quality kidney from a living donor under anesthesia which makes the impact of modest increase in CIT minimal. Segev et al [13] reported no DGF and excellent immediate graft function despite a median CIT of 7.2 hours in 56 live donor transplants where kidneys were transported to the intended recipient. In our single center experience, CIT for the transported kidneys was 13.1 ± 6.6 hours without any adverse outcomes in patients undergoing PEKT [14].…”

Section: Concern For Prolonged Cold Ischemia With Donor Kidney Transportmentioning

confidence: 99%

Paired Exchange: A New Innovation in Live Donor Kidney Transplantation

Arora¹

2014

J Nephrol Ther

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Barriers to traditional living-donor kidney transplantation include ABO incompatibility and positive cross-match. Paired exchange kidney transplantation (PEKT) is a viable an increasingly popular method to increase live donation. We discuss the pros and cons as well as the various ways to achieve PEKT along with a review of existing literature. To achieve the full potential of PEKT, the transplant community at large needs to work toward a national kidney paired donation program along with a centralized financial intermediary.

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Transporting Live Donor Kidneys for Kidney Paired Donation: Initial National Results

Cited by 76 publications

References 13 publications

Comparison of Kidney Paired Donation Transplantations with Living Related Donor Kidney Transplantation: Implications for National Kidney Paired Donation Program

Comparison of Kidney Paired Donation Transplantations with Living Related Donor Kidney Transplantation: Implications for National Kidney Paired Donation Program

Chain Transplantation: Initial Experience of a Large Multicenter Program

Paired Exchange: A New Innovation in Live Donor Kidney Transplantation

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