Wednesday, May 31, 2017

Kidney donation today on behalf of a future recipient

Here's a forthcoming article in Transplantation, interesting for both what it says and who says it.

The authors include prominent transplant professionals at UCLA (which is an important, innovative and productive kidney transplant center), and also the rising-star economist and matching theorist Marek Pycia.  I recall a time when collaborations between economists and transplant professionals was unusual, and so I'm glad to see new collaborations of that sort arise.

The paper itself is about taking future care of young kidney patients who may need a (second or third) kidney donation later in life. The NKR and UCLA are implementing a voucher system that would allow a donor (e.g. the young patient's grandparent, or parent) to donate as a non-directed donor today, on behalf of a specific, current kidney patient, in return for a commitment that best efforts would be made to end some future kidney exchange chain with a chain-ending kidney for the designated patient, when the need arises.

Vouchers for Future Kidney Transplants to Overcome ‘Chronological
Incompatibility’ Between Living Donors and Recipients
Jeffrey L. Veale, M.D., , Alexander M. Capron, Nima Nassiri, Gabriel Danovitch, H. Albin Gritsch, Joseph Del Pizzo, Jim C. Hu, Marek Pycia, Suzanne McGuire, Marian Charlton, and Sandip Kapur,

Transplantation Published Ahead of Print DOI: 10.1097/TP.0000000000001744

Background: The waiting list for kidney transplantation is long and growing. The creation of :vouchers" for future kidney transplants enables living donation to occur when optimal for the donor and transplantation to occur later, when and if needed by the recipient.

Methods: The donation of a kidney at a time that is optimal for the donor generates a :voucher‘" that only a specified recipient may redeem later when needed. The voucher provides the recipient with priority in being matched with a living donor from the end of a future transplantation chain. Besides its use in persons of advancing age with a limited window for donation, vouchers remove a disincentive to kidney donation, namely, a reluctance to donate now lest one‘s family member should need a transplant in the future.

Results: We describe the first 3 voucher cases, in which advancing age might otherwise have deprived the donors the opportunity to provide a kidney to a family member. These 3 voucher donations functioned in a nondirected fashion and triggered 25 transplants through kidney paired donation across the United States

See my earlier post: 

Thursday, August 4, 2016

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