Sunday, July 5, 2020

Czech-Austrian and Swedish-Danish kidney exchange

Overcoming borders makes the market thicker.

Here's a paper on kidney exchange across between Austria and the Czech Republic from the most recent edition of Transplant International:

Crossing borders to facilitate live donor kidneytransplantation: the Czech-Austrian kidney paired donation program – a retrospective study 
Ondrej Viklicky1 , Sebastian Krivanec2 , Hana Vavrinova1 , Gabriela Berlakovich3 , Tomas Marada4 , Janka Slatinska1 , Tereza Neradova4 , Renata Zamecnikova4 , Andreas Salat3 , Michael Hofmann3 , Gottfried Fischer5 , Antonij Slavcev6 , Pavel Chromy4 , Rainer Oberbauer2 , Tomas Pantoflicek4 , Sabine Wenda5 , Elisabeth Lehner2 , Ingrid Fae5 , Paolo Ferrari7,8,9 , Jiri Fronek4 & Georg A. Bohmig

SUMMARY Kidney paired donation (KPD) is a valuable tool to overcome immunological barriers in living donor transplantation. While small national registries encounter difficulties in finding compatible matches, multi-national KPD may be a useful strategy to facilitate transplantation. The Czech (Prague) and Austrian (Vienna) KPD programs, both initiated in 2011, were merged in 2015. A bi-national algorithm allowed for ABO- and low-level HLA antibody-incompatible exchanges, including the option of altruistic donor initiated domino chains. Between 2011 and 2019, 222 recipients and their incompatible donors were registered. Of those, 95.7% (Prague) and 67.9% (Vienna) entered into KPD registries, and 81 patients received a transplant (95% 3-year graft survival). Inclusion of ABO-incompatible pairs in the Czech program contributed to higher KPD transplant rates (42.6% vs. 23.6% in Austria). After 2015 (11 bi-national match runs), the median pool size increased to 18 pairs, yielding 33 transplants (8 via cross-border exchanges). While matching rates doubled in Austria (from 9.1% to 18.8%), rates decreased in the Czech program, partly due to implementation of more stringent HLA antibody thresholds. Our results demonstrate the feasibility of merging small national KPD programs to increase pool sizes and may encourage the implementation of multi-national registries to expand the full potential of KPD.
And here's a paper on kidney exchange between Sweden and Denmark:

De första njurbytena mellan två skandinaviska länder är gjorda
The first kidney exchanges between two Scandinavian countries are made
Scandinavian expansion of the renal exchange program STEP
Tommy Andersson, Professor, Lars Wennberg , Per Lindnér, Ilse Duus Weinreich, Karin Skov, Claus Bistrup

SUMMARY: The first kidney exchanges between two Scandinavian countries have been performed
This article describes the Scandinavian expansion of the previously described kidney exchange program STEP, and the first two exchanges performed between two Scandinavian countries late in 2019. All surgical procedures were performed simultaneously and / or coordinated at different hospitals in Scandinavia and the kidney grafts were transported between the participating units. Four weeks after surgery, all recipients had a good and stable kidney function and all donors had recovered.

see earlier post:

Wednesday, December 25, 2019

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