Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India

摘要

AIM To avoid desensitization protocols and ABO incompatible kidney transplantation(KT) due to high costs and increased risk of infections from intense immunosuppression.METHODS We present institutional ethical review board- approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility(n = 1); positive cross-match and/or presence of donor specific antibody(n = 5). The average time required from registration in kidney paired donation(KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo. RESULTS Graft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection(Banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo followup. The waiting time in KPD was short as compared to deceased donor KT. CONCLUSION We report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.