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Related Experiment Videos

Donor kidney exchanges.

Francis L Delmonico1, Paul E Morrissey, George S Lipkowitz

  • 1New England Organ Bank, Newton, MA, USA. francis_delmonico@neob.org

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|September 16, 2004
PubMed
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Kidney paired and live donor/list exchanges overcome ABO and HLA incompatibility, expanding live donor kidney transplantation. This system increases deceased donor kidney access for waiting recipients.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Organ Donation

Background:

  • Live donor kidney transplantation offers excellent outcomes, even with human leukocyte antigen (HLA) mismatches.
  • Hyperacute rejection historically limited transplants between ABO blood type or HLA antibody incompatible donor-recipient pairs.
  • The United Network for Organ Sharing (UNOS) Region 1 developed innovative exchange programs to address these limitations.

Purpose of the Study:

  • To describe a regional kidney exchange system facilitating transplantation for ABO-incompatible or crossmatch-reactive recipients.
  • To evaluate the benefits of paired exchange and live donor/list exchange models.
  • To assess the impact of these exchanges on deceased donor kidney availability.

Main Methods:

  • Implementation of a regional kidney exchange program by UNOS Region 1.

Related Experiment Videos

  • Facilitation of simultaneous live donor exchanges (paired exchange).
  • Arrangement of live donor/deceased donor exchanges for incompatible recipients on the waiting list (live donor/list exchange).

    • Main Results:

    • Successful transplantation for recipients previously ineligible due to ABO or HLA incompatibility.
    • Expansion of live donor kidney transplantation opportunities.
    • Increased availability of deceased donor kidneys for remaining candidates on the waiting list.

    Conclusions:

    • Regional kidney exchange programs effectively overcome ABO and crossmatch incompatibilities.
    • These innovative systems enhance live donor kidney transplantation and improve access to deceased donor organs.
    • The exchange model benefits both incompatible recipients and the broader deceased donor waiting list population.