Transplantation With Kidney Paired Donation to Increase the Donor Pool: A Single-Center Experience

Gumber, Manoj R.; Kute, Vivek B.; Goplani, Kamal R; Shah, Pankaj; Patel, Himanshu V.; Vanikar, Aruna V; Pandya, Tapan; Trivedi, Hargovind L

doi:10.1016/j.transproceed.2011.02.016

Cited by 14 publications

(7 citation statements)

References 21 publications

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“…(45 years). [ 6 ] Mean recipient age was 46.73 ± 9.71 years, which was relatively higher compared to above two studies (40.9 years and 36 years, respectively). Mean waiting time on dialysis was 4.9 ± 2.77 months.…”

Section: Discussionmentioning

confidence: 60%

Paired kidney exchange transplantation: Maximizing the donor pool

P¹,

Sethi²,

Bansal³

et al. 2015

Indian J Nephrol

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In the last decade, paired kidney exchange (PKE) transplantation has gained popularity worldwide as a viable alternative for end stage renal disease (ESRD) patients who have incompatible or sensitized donors. This study presents our experience with PKE transplantation and compares outcome between PKE and non-PKE renal transplant recipients. Between February 2010 and November 2013, 742 transplants were performed, of which 26 (3.5%) were PKE transplantations. All were two-way exchanges. PKE recipients were significantly older than non-PKE (46.73 ± 9.71 vs. 40.08 ± 13.36 years; P = 0.012) while donor ages were comparable. PKE patients had significantly higher number of HLA mismatches (5.03 ± 1.14 vs. 3.49 ± 1.57; P < 0.0001). After a median follow-up of 20 months (range: 3–47 months), there was no significant difference in patient survival (PKE 96.16% vs. non-PKE 96.65%; P = 0.596) and death censored graft survival (PKE 96.16% vs. non-PKE 96.37%; P = 1). Mean serum creatinine at 1 month and at last follow-up was lower in PKE versus non-PKE group (0.98 ± 0.33 vs. 1.3 ± 0.61 mg/dl; P = 0.008 and 0.96 ± 0.30 vs. 1.27 ± 0.57 mg/dl, P = 0.006, respectively). Biopsy proven acute rejection rate was 11.5% in PKE group and 16.89% in non-PKE patients (P = 0.6). To conclude, paired kidney donation is an excellent way of increasing the donor pool and needs to be promoted to overcome the shortage of suitable kidney in our country.

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Section: Discussionmentioning

confidence: 60%

Paired kidney exchange transplantation: Maximizing the donor pool

P¹,

Sethi²,

Bansal³

et al. 2015

Indian J Nephrol

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“…Internet‐based communication tools should be used to connect with other incompatible pairs . Our report showed that different KPD forms (Table ) can be successfully applied in any country with limited resources .…”

Section: Discussionmentioning

confidence: 91%

“…A large‐volume transplant centre can employ a single‐centre KPD programme when national programmes do not exist. A single‐centre KPD programme is easy and less costly than the national KPD programme ; it avoids challenges for the travelling donor due to variability between donor work up and donor surgery and eliminates potential barriers in multicentre programmes, such as donor travel, shipping of kidney, follow‐up care and disparity in healthcare cost and quality. Smaller centres should initially focus on easy‐to‐match pairs and employ multicentre KPD programmes to reduce waiting time and improve the quality and quantity of matches.…”

Section: Discussionmentioning

confidence: 99%

“…KPD is underutilized in India due to the lack of a KPD registry in the national programme; a lack of single‐centre KPD practice; a lack of harmony and coordination among different transplant units; variable healthcare costs and quality; a lack of uniform evaluation and follow‐up care for transplant patients and donors; inefficient matching algorithms; and legal, regulatory, logistical and economic barriers. Our centre in Ahmedabad, India, has pioneered KPD transplantation over the last few years . KPD has increased access to LDKT in national and single‐centre programmes across the world .…”

Section: Introductionmentioning

confidence: 99%

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Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

et al. 2017

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In a living donor kidney transplantation (LDKT) dominated transplant programme, kidney paired donation (KPD) may be a cost-effective and valid alternative strategy to increase LDKT in countries with limited resources where deceased donation kidney transplantation (DDKT) is in the initial stages. Here, we report our experience of 300 single-centre KPD transplantations to increase LDKT in India. Between January 2000 and July 2016, 3616 LDKT and 561 DDKT were performed at our transplantation centre, 300 (8.3%) using KPD. The reasons for joining KPD among transplanted patients were ABO incompatibility (n = 222), positive cross-match (n = 59) and better matching (n = 19). A total of 124 two-way (n = 248), 14 three-way (n = 42), one four-way (n = 4) and one six-way exchange (n = 6) yielded 300 KPD transplants. Death-censored graft and patient survival were 96% (n = 288) and 83.3% (n = 250), respectively. The mean serum creatinine was 1.3 mg/dl at a follow-up of 3 ± 3 years. We credit the success of our KPD programme to maintaining a registry of incompatible pairs, counselling on KPD, a high-volume LDKT programme and teamwork. KPD is legal, cost effective and rapidly growing for facilitating LDKT with incompatible donors. This study provides large-scale evidence for the expansion of single-centre LDKT via KPD when national programmes do not exist.

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“…In India, in the absence of national KPD program, only single-center KPD is practiced. [ 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ] Table 2 shows the key elements of success of single-center KPD program at the Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India, a center which has performed 300 KPD transplants in India. [ 2 3 4 5 6 7 8 9 10 ]…”

Section: Kidney-paired Donation In Indiamentioning

confidence: 99%