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.
journal_name
Transplantationjournal_title
Transplantationauthors
Li H,Stegall MD,Dean PG,Casey ET,Reddy KS,Khamash HA,Heilman RL,Mai ML,Taner CB,Kosberg CL,Bakken LL,Wozniak EJ,Giles KL,Veal LA,Gandhi MJ,Cosio FG,Prieto Mdoi
10.1097/TP.0000000000000054subject
Has Abstractpub_date
2014-08-15 00:00:00pages
300-5issue
3eissn
0041-1337issn
1534-6080journal_volume
98pub_type
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