Seventy-seven kidney paired donation transplantations at a single transplant centre in India led to an increase in living donor kidney transplantations in 2015

摘要

Background To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications. Methods This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs. During this period, a total of 380 kidney transplantations [71 deceased donor kidney transplantations (DDKTs), 309 LDKTs] were performed. The reasons for opting for KPD were ABO incompatibility ( n =?45), sensitization ( n =?26) and better matching ( n =?6). Results KPD matching was facilitated in 62% ( n =?98) of transplants. In all, 48.7% ( n =?77) of the transplants were completed in 2015, whereas 13.3% ( n =?21) of the matched patients were to undergo transplant surgery in early 2016 after getting legal permission. The waiting time for KPD was shorter compared with DDKT. The death-censored graft survival and patient survival were 98.7% ( n =?76) and 93.5% ( n =?72), respectively. In all, 14.2% ( n =?11) of patients had acute rejection. Match rates among sensitized ( n =?60) and O group patients ( n =?62) were 58.3% ( n =?35) and 41.9% ( n =?26), respectively. Of these, 43.3% ( n =?26) and 29% ( n =?18) of transplants were completed and 15% ( n =?9) and 12.9% ( n =?8), respectively, are waiting for legal permission. Conclusions LDKT increased by 25% in 1 year in our single-centre KPD programme. Our key to success was the formation of a KPD registry, awareness and active counselling programs and developing a dedicated team.