Assessing the efficacy of kidney paired donation-performance of an integrated three-site program

Han Li, Mark D. Stegall, Patrick G. Dean, Edward T. Casey, Kunam S. Reddy, Hasan A. Khamash, Raymond L. Heilman, Martin L. Mai, C. Burcin Taner, Catherine L. Kosberg, Lisa L. Bakken, Elmira J. Wozniak, Kathleen L. Giles, Lisa A. Veal, Manish J. Gandhi, Fernando G. Cosio, Mikel Prieto

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND: Kidney paired donation (KPD) has emerged as a viable option for renal transplant candidates with incompatible living donors. The aim of this study was to assess the "performance" of a three-site KPD program that allowed screening of multiple donors per recipient. METHODS: We reviewed retrospectively the activity of our KPD program involving three centers under the same institutional umbrella. The primary goal was to achieve a transplant that was both ABO compatible and had a negative or low-positive flow cytometric crossmatch (+XM). RESULTS: During the 40-month study period, 114 kidney transplant candidates were enrolled-57% resulting from a +XM and 39% resulting from ABO incompatible (ABOi) donors. Important outcomes were as follows: (1) 81 (71%) candidates received a transplant and 33 (29%) were still waiting; (2) 368 donors were evaluated, including 10 nondirected donors; (3) 82% (37/45) of ABOi candidates underwent transplantation; (4) 56% (36/65) of +XM candidates underwent transplantation (however, all but four of these had a cPRA less than 95%); (5) at the end of the study period, 97% (28/29) of +XM candidates still waiting had a cPRA greater than 95%. CONCLUSIONS: These data suggest evaluating large numbers of donors increases the chances of KPD. Patients with a cPRA greater than 95% are unlikely to receive a negative or low-positive +XM, suggesting the need for desensitization protocols in KPD.

Original languageEnglish (US)
Pages (from-to)300-305
Number of pages6
JournalTransplantation
Volume98
Issue number3
DOIs
StatePublished - Aug 15 2014

Keywords

  • ABO incompatible kidney transplantation
  • Allosensitization
  • Kidney paired donation
  • Kidney transplantation
  • Positive crossmatch kidney transplantation

ASJC Scopus subject areas

  • Transplantation

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