Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

Impact of single centre kidney paired donation transplantation to increase donor pool in India: a cohort study

In a living donor kidney transplantation (LDKT) dominated transplant programme, kidney paired donation (KPD) may be a cost-effective and valid alternative strategy to increase LDKT in countries with limited resources where deceased donation kidney transplantation (DDKT) is in the initial stages. Her...

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Bibliographic Details
Published in:Transplant international Vol. 30; no. 7; p. 679
Main Authors: Kute, Vivek B, Patel, Himanshu V, Shah, Pankaj R, Modi, Pranjal R, Shah, Veena R, Rizvi, Sayyed J, Pal, Bipin C, Shah, Priyadarshini S, Modi, Manisha P, Butala, Beena P, Wakhare, Pavan S, Varyani, Umesh T, Shinde, Saiprasad G, Ghodela, Vijay A, Kasat, Govind S, Patil, Mayur V, Patel, Jaydeep C, Kumar, Deepk P, Trivedi, Varsha B, Patel, Minaxi H, Trivedi, Hargovind L
Format: Journal Article
Language:English
Published: England 01-07-2017
Subjects:
Adolescent
Adult
Aged
Child
Cohort Studies
Directed Tissue Donation - statistics & numerical data
Female
Graft Survival
Histocompatibility Testing
Humans
India - epidemiology
Kaplan-Meier Estimate
Kidney Transplantation - methods
Kidney Transplantation - mortality
Kidney Transplantation - statistics & numerical data
Living Donors - statistics & numerical data
Male
Middle Aged
Registries
Tissue and Organ Procurement - methods
Tissue and Organ Procurement - statistics & numerical data
Young Adult
graft survival
living donor kidney transplantation
patient survival
end-stage renal disease
kidney paired donation
kidney transplantation
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Summary:In a living donor kidney transplantation (LDKT) dominated transplant programme, kidney paired donation (KPD) may be a cost-effective and valid alternative strategy to increase LDKT in countries with limited resources where deceased donation kidney transplantation (DDKT) is in the initial stages. Here, we report our experience of 300 single-centre KPD transplantations to increase LDKT in India. Between January 2000 and July 2016, 3616 LDKT and 561 DDKT were performed at our transplantation centre, 300 (8.3%) using KPD. The reasons for joining KPD among transplanted patients were ABO incompatibility (n = 222), positive cross-match (n = 59) and better matching (n = 19). A total of 124 two-way (n = 248), 14 three-way (n = 42), one four-way (n = 4) and one six-way exchange (n = 6) yielded 300 KPD transplants. Death-censored graft and patient survival were 96% (n = 288) and 83.3% (n = 250), respectively. The mean serum creatinine was 1.3 mg/dl at a follow-up of 3 ± 3 years. We credit the success of our KPD programme to maintaining a registry of incompatible pairs, counselling on KPD, a high-volume LDKT programme and teamwork. KPD is legal, cost effective and rapidly growing for facilitating LDKT with incompatible donors. This study provides large-scale evidence for the expansion of single-centre LDKT via KPD when national programmes do not exist.
ISSN:1432-2277
DOI:10.1111/tri.12956