Clinical Results From Transplanting Incompatible Live Kidney Donor/Recipient Pairs Using Kidney Paired Donation

Montgomery, Robert A.; Zachary, Andrea A.; Ratner, Lloyd E.; Segev, Dorry L.; Hiller, Janet; Houp, Julie A.; Cooper, Mathew; Kavoussi, Louis R.; Jarrett, Thomas W.; Burdick, James F.; Maley, Warren R.; Melancon, J. Keith; Kozłowski, Tomasz; Simpkins, Christopher E.; Phillips, Melissa S.; Desai, A.; Collins, V; Reeb, Brigitte; Kraus, Edward S.; Rabb, Hamid; Leffell, Mary S.; Warren, Daniel

doi:10.1001/jama.294.13.1655

Cited by 173 publications

(112 citation statements)

References 30 publications

Supporting

Mentioning

110

Contrasting

Order By: Relevance

“…There were relatively few living donors aged $60 years to permit detailed subgroup analyses, and there may be certain patient subgroups who tolerate dialysis relatively well in whom continued waiting on dialysis may be a reasonable consideration. The information provided in this study can be further supplemented with published information regarding the probability of finding a match in a LDPE program to inform clinical decision making (2,3,11,12). A formal decision analysis may provide additional useful information but is beyond the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

Living Donor Age and Kidney Allograft Half-Life

Chang

Gill

Dong

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Living donor paired exchange programs assume that kidneys from living donors are of comparable quality and anticipated longevity. This study determined actual allograft t 1/2 within different recipient age groups (10-year increments) as a function of donor age (5-year increments), and juxtaposed these results against the probabilities of deceased donor transplantation, and exclusion from transplantation (death or removal from the wait-list). Results With the exception of recipients aged 18-39 years, who had the best outcomes with donors aged 18-39 years, living donor age between 18 and 64 years had minimal effect on allograft t 1/2 (difference of 1-2 years with no graded association). The probability of deceased donor transplantation after 3 years of wait-listing ranged from 21% to 66% by blood type and level of sensitization, whereas the probability of being excluded from transplantation ranged from 6% to 27% by age, race, and primary renal disease.Conclusions With the exception of recipients aged 18-39 years, living donor age between 18 and 64 years has minimal effect on allograft survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Living Donor Age and Kidney Allograft Half-Life

Chang

Gill

Dong

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…A donor and recipient who have incompatible blood groups or HLA sensitivity can be matched with another incompatible pair, to result in two compatible transplants (fi gure). [13][14][15][16][17][18][19] Although there are many ways to match up a pool of incompatible pairs, the mathematical technique of optimisation helps to fi nd out which matches will yield the best results. 13 Nevertheless, even in paired-donation programmes in which mathematical optimisation is applied, more than 50% of the incompatible pairs in the pool remain unmatched.…”

mentioning

confidence: 99%

Domino paired kidney donation: a strategy to make best use of live non-directed donation

et al. 2006

View full text Add to dashboard Cite

“…11 Furthermore, we can quantify the increase in the expected number of transplants from pooling the patient-donor pairs from multiple hospitals. For this, let µ(n) denote the expected cardinality of a maximum matching on a random graph G n .…”

Section: And the Expected Value Ofmentioning

confidence: 99%

“…The scarcity of cadaver kidneys coupled with the significant medical benefits from live kidney transplants has prompted the advance of kidney-paired donation (KPD), also referred to as kidney exchanges, in recent years [11]. In KPD, a patient with an incompatible donor can form a patient-donor pair and, by entering a kidney exchange program, match with one or more other pairs, so that the patient receives a compatible kidney and the donor donates a kidney to some other patient.…”

Section: Introductionmentioning

confidence: 99%

Design and analysis of multi-hospital kidney exchange mechanisms using random graphs

Toulis

Parkes

2015

Games and Economic Behavior

View full text Add to dashboard Cite

Kidney exchanges enable transplants when a pair of a patient and an incompatible donor is matched with other similar pairs. In multi-hospital kidney exchanges pairs are pooled from multiple hospitals, and each hospital is able to decide which pairs to report and which to hide and match locally. Modeling the problem as a maximum matching on a random graph, we first establish that the expected benefit from pooling scales as the square-root of the number of pairs in each hospital. We design the xCM mechanism, which achieves efficiency and incentivizes hospitals of moderate-to-large size to fully report their pairs. Reciprocal pairs are crucial in the design, with the probabilistic uniform rule used to ensure incentive alignment. By grouping certain pair types into so-called virtual-reciprocal pairs, xCM extends to handle 3-cycles. We validate the performance of xCM in simulation, demonstrating its efficiency and incentive advantages over the Bonus mechanism [3].Keywords: kidney exchange, random graphs, mechanism design, maximum $ This is a significantly revised version of an extended abstract that appeared in ACM EC'11. In addition to a modified mechanism and an extension to 3-cycles, we also provide complete proofs and extensive simulation results. We wish to thank Itai Ashlagi, Ian Kash, Felix Fischer, Les Valiant and the reviewers from EC'11 for comments on an earlier version, as well as the reviewers and the Associate Editor at GEB.

show abstract

Clinical Results From Transplanting Incompatible Live Kidney Donor/Recipient Pairs Using Kidney Paired Donation

Cited by 173 publications

References 30 publications

Living Donor Age and Kidney Allograft Half-Life

Living Donor Age and Kidney Allograft Half-Life

Domino paired kidney donation: a strategy to make best use of live non-directed donation

Design and analysis of multi-hospital kidney exchange mechanisms using random graphs

Contact Info

Product

Resources

About