Characteristics of compatible pair participants in kidney paired donation at a single center

Weng, Francis L.; Grogan, T. R.; Patel, Anup; Mulgaonkar, Shamkant; Morgievich, M.

doi:10.1111/ctr.12978

Cited by 10 publications

(11 citation statements)

References 24 publications

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“…An important finding in this study is that the prospect of facilitating transplantation among additional patients in and of itself appears to be a strong motivator for TCs to consider KPD, and, in both surveys and interviews, was cited as the most important factor driving their desire to participate as a compatible pair. As in prior studies, 6,8,22,23 finding a "better match" or medical advantage for the intended TC was also cited by both PLDs and TCs as an important motivator for participating in KPD and has the potential to further increase willingness to participate as a compatible pair.…”

Section: Discussionmentioning

confidence: 65%

“…4,5 In 2010, Ratner and colleagues first described the participation of 2 compatible pairs in a kidney chain and reported a certain ambivalence toward participating as a compatible pair in KPD. 6 In 2012, Bingaman et al 7 reported the participation of 17 compatible pairs in their kidney exchange programs, and, more recently, Weng et al 8 described the participation of 11 compatible pairs in their single-center KPD program.…”

Section: Introductionmentioning

confidence: 99%

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Compatible Donor and Recipient Pairs’ Perspectives on Participation in Kidney Paired Donation Programs: A Mixed-Methods Study

Fortin

Gill

Allard

et al. 2021

Can J Kidney Health Dis

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Background: Compatible pair participation in kidney paired donation (KPD) may increase the likelihood of finding suitable matches for all registered pairs. Retrospective studies have shown variable enthusiasm for participating in KPD in compatible pairs. Objective: The study objective was to gather potential living donor (PLD) and transplant candidate (TC) perspectives on compatible pair participation in KPD. Design: Surveys and qualitative interviews. Setting: Three transplant programs in Canada: Centre hospitalier de l’Université de Montréal in Montreal (Québec), Vancouver General Hospital, and St. Paul’s Hospital in Vancouver (British Columbia). Patients: Both PLDs and TCs undergoing evaluation for donation/transplantation between 2016 and 2018 at 3 transplant programs in Canada. Methods: Descriptive statistical analysis was performed for the results of the survey and thematic and content analysis method was used for the content of the qualitative interviews. Results: A total of 116 PLDs and 111 TCs completed surveys and an additional 18 PLDs and 17 TCs underwent semi-directed interviews. Of those surveyed, 61.2% of PLDs and 76.6% of TCs reported a willingness to participate in KPD as a compatible pair. The possibility of a more optimally matched kidney for the TC and policies ensuring prioritization of the TC for repeat transplantation in the event of early graft failure increased willingness to participate in KPD. Major concerns expressed during the interviews included the desire to retain the emotional bond of directed donation, the fear of chain breaks or donor reneging, delays in transplantation, and additional travel associated with participation in KPD. Limitation: The limitations of this study are that it was conducted in only 3 Canadian transplant programs and that the interviews and surveys were in French and in English. As a consequence, the results may not be reflective of the views of individuals not living in these 2 provinces and from ethnic minority populations. Conclusion: Most of the compatible PLDs and TCs surveyed were willing to participate in KPD. Ensuring timely transplantation and a more optimal match for TCs and offering a policy of reciprocity to ensure timely repeat transplantation for compatible recipients if their allograft fails post KPD transplant may further increase compatible pair participation in KPD.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Compatible Donor and Recipient Pairs’ Perspectives on Participation in Kidney Paired Donation Programs: A Mixed-Methods Study

Fortin

Gill

Allard

et al. 2021

Can J Kidney Health Dis

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“…Future studies should also consider how paired exchange networks can ensure equipoise for all compatible pairs. While NKR is the largest single network for paired exchange, other networks have reported use of compatible pairs with varying measures of match quality 9,13,14 . Several investigators have suggested approaches to improve the ethical use of compatible pairs in paired exchange including a “reciprocity‐based strategy.” 23 Gill et al suggest prioritizing deceased donor allocation for paired exchange recipients who were originally part of a compatible pair; this would protect from graft failures over a 10‐year horizon.…”

Section: Discussionmentioning

confidence: 99%

“…Donor–recipient pairs that receive satisfaction in an altruistic act may seek biological equipoise. Other donor–recipient pairs may seek donors of younger age, larger nephron mass, fewer HLA mismatches, or general donor quality measured by the living donor kidney profile index (LKDPI) 13–17 …”

Section: Introductionmentioning

confidence: 99%

Motivations and outcomes of compatible living donor–recipient pairs in paired exchange

Chipman

Cooper

Thomas

et al. 2022

American Journal of Transplantation

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Increasing numbers of compatible pairs are choosing to enter paired exchange programs, but motivations, outcomes, and system‐level effects of participation are not well described. Using a linkage of the Scientific Registry of Transplant Recipients and National Kidney Registry, we compared outcomes of traditional (originally incompatible) recipients to originally compatible recipients using the Kaplan–Meier method. We identified 154 compatible pairs. Most pairs sought to improve HLA matching. Compared to the original donor, actual donors were younger (39 vs. 50 years, p < .001), less often female (52% vs. 68%, p < .01), higher BMI (27 vs. 25 kg/m², p = .03), less frequently blood type O (36% vs. 80%, p < .001), and had higher eGFR (99 vs. 94 ml/min/1.73 m², p = .02), with a better LKDPI (median 7 vs. 22, p < .001). We observed no differences in graft failure or mortality. Compatible pairs made 280 additional transplants possible, many in highly sensitized recipients with long wait times. Compatible pair recipients derived several benefits from paired exchange, including better donor quality. Living donor pairs should receive counseling regarding all options available, including kidney paired donation. As more compatible pairs choose to enter exchange programs, consideration should be given to optimizing compatible pair and hard‐to‐transplant recipient outcomes.

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“…Studies have reported the success of kidney transplantation across the blood group barrier (23,24), but the risks for severe infection, antibody-mediated rejection, and postoperative bleeding were all increased in an ABO-incompatible patient groups. Britta (27).…”

Section: Discussionmentioning

confidence: 99%

The Potential Significance of ABO Genotyping for Donor Selection in Kidney Transplantation

Zhou

Wang

et al. 2020

Front. Immunol.

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Background: The ABO blood group system is clinically important in kidney transplantation, but ABO genotyping fails to attract sufficient attention in some countries and regions. We identified one case of early graft dysfunction due to an ABO genotype mismatch. Here, we performed ABO genotyping in blood samples, analyzed grouping discrepancies, and investigated the weak A subgroup frequency in kidney transplantation candidates. Methods: Blood samples from 302 uremic patients with grouping discrepancies and 356 uremic patients with type A blood were analyzed using standard serologic serotyping techniques. The ABO genotypes and alleles were analyzed by polymerase chain reaction sequence-specific primer (PCR-SSP) and sequence-based typing (PCR-SBT). Results: All 302 uremic patients with grouping discrepancies carried weak ABO subgroup alleles and 77.48% carried irregular ABO antibodies. The discrepancy rate between serotyping and genotyping was 42.38%, and the mismatching rate of donor selection according to serotype reached 88.74%. And 2.53% of 356 uremic patients with type A blood were determined to be in the weak A subgroup, which was a higher percentage than that observed in the healthy Chinese population (0.53%) by serological screening, but much lower than that observed in Caucasians (20%). Conclusion: We revealed the high risk of blood type misjudgment and genetically ABOmismatched transplantation if serological test was performed only in blood-group typing. Improved precision of ABO genotyping is crucial for successful kidney transplantation and reasonable organ allocation.

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Characteristics of compatible pair participants in kidney paired donation at a single center

Cited by 10 publications

References 24 publications

Compatible Donor and Recipient Pairs’ Perspectives on Participation in Kidney Paired Donation Programs: A Mixed-Methods Study

Compatible Donor and Recipient Pairs’ Perspectives on Participation in Kidney Paired Donation Programs: A Mixed-Methods Study

Motivations and outcomes of compatible living donor–recipient pairs in paired exchange

The Potential Significance of ABO Genotyping for Donor Selection in Kidney Transplantation

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