Kidney paired donation

Abstract

In "Unrecognized Opportunities," Victoria Cassell and colleagues dive into a topic rarely discussed in pediatrics: Kidney Paired Donation (KPD). The study outlines the current state of KPD in pediatrics, demonstrating that while KPD rates have increased in recent years, the rates are overall small and occur in few centers across the nation. The paper also goes on to describe how outcomes are similar for KPD to non-KPD Living Donor Kidney Transplants (LDKT), for at least the short-term outcomes included. The authors call upon increased utilization of KPD in pediatric patients as an opportunity to expand transplant access.The authors are correct that the increased use of KPD is needed. Analysis of current transplant policy shows decreased access to DDKT for children. Since the enactment of the 2014 Kidney Allocation System (KAS), wait times for DDKT increased, and DDKT rates decreased for young children. 1,2 Current policy remains in flux as we move towards a continuous distribution model for organ allocation; a system aimed at eliminating geographic boundaries and instead using a composite allocation score. 3 The pediatric nephrology community remains diligent in advocating for pediatric priority, yet pediatric status in final scoring has yet to be determined and how this new scoring system will impact access remains to be seen.