Monday, April 11, 2016

Using deceased donor kidneys to start living donor kidney exchange chains

In American kidney exchange, living non-directed kidney donors initiate chains that produce an average of five transplants.Deceased donor kidneys are also non-directed, but produce one transplant each.  Here's the abstract for a forthcoming paper in the American Journal of Transplantation (AJT), suggesting that it would be helpful to use some deceased donor kidneys to initiate nondirected donor chains:

Abstract: We propose that some deceased donor (DD) kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor (LD) kidney transplants to address, in part, the huge disparity between patients on the DD kidney waitlist and available donors. The use of DD kidneys for this purpose would benefit waitlisted candidates in that most patients enrolled in kidney paired donation (KPD) systems are also waitlisted for a DD kidney transplant, and receiving a kidney through the mechanism of KPD will decrease pressure on the DD pool. In addition, a LD kidney usually provides survival potential equal or superior to that of DD kidneys. If KPD chains that are initiated by a DD can end in a donation of an LD kidney to a candidate on the DD waitlist, the quality of the kidney allocated to a waitlisted patient is likely to be improved. We hypothesize that a pilot program would show a positive impact on patients of all ethnicities and blood types.

Here's the link to the journal page

  1. M. L. Melcher1
  2. J. P. Roberts2,*
  3. A. B. Leichtman3
  4. A. E. Roth4 and
  5. M. A. Rees5,6
Article first published online: 9 MAR 2016
DOI: 10.1111/ajt.13740

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