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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Paired kidney exchange transplantation: Maximizing the donor pool.

P K Jha1, S Sethi1, S B Bansal1

  • 1Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India.

Indian Journal of Nephrology
|December 15, 2015
PubMed
Summary

Paired kidney exchange (PKE) transplantation offers a successful alternative for end-stage renal disease patients with incompatible donors. This study found PKE transplantation comparable to non-PKE in survival and rejection rates, with better kidney function.

Keywords:
Developing worldIndiakidney transplantpaired kidney exchange

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Surgical Innovation

Background:

  • End-stage renal disease (ESRD) patients with incompatible or sensitized donors face challenges in receiving kidney transplants.
  • Paired kidney exchange (PKE) transplantation has emerged as a significant alternative to increase transplant rates.
  • This study evaluates the outcomes of PKE transplantation compared to traditional non-PKE recipients.

Purpose of the Study:

  • To compare the clinical outcomes of PKE transplantation with non-PKE renal transplantation.
  • To assess patient survival, graft survival, and renal function in both groups.
  • To determine the feasibility and effectiveness of PKE as a strategy to expand the donor pool.

Main Methods:

  • Retrospective analysis of 742 renal transplants performed between February 2010 and November 2013.
  • Comparison of PKE (n=26) and non-PKE (n=716) recipients based on age, HLA mismatches, patient survival, death-censored graft survival, serum creatinine levels, and acute rejection rates.
  • Median follow-up of 20 months.

Main Results:

  • PKE recipients were older (46.73 vs. 40.08 years) and had more HLA mismatches (5.03 vs. 3.49).
  • No significant differences were observed in patient survival (96.16% vs. 96.65%) or death-censored graft survival (96.16% vs. 96.37%) between PKE and non-PKE groups.
  • PKE recipients showed significantly lower mean serum creatinine levels at 1 month (0.98 vs. 1.3 mg/dl) and last follow-up (0.96 vs. 1.27 mg/dl).
  • Biopsy-proven acute rejection rates were comparable (11.5% vs. 16.89%).

Conclusions:

  • Paired kidney exchange transplantation is a safe and effective method for increasing kidney transplant rates.
  • PKE transplantation demonstrates comparable long-term outcomes to non-PKE transplantation.
  • Promoting PKE is crucial for addressing the organ donor shortage and improving outcomes for ESRD patients.