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Kidney exchange transplantation current status, an update and future perspectives
Vivek B Kute1, Narayan Prasad2, Pankaj R Shah3
1Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India. drvivekkute@rediffmail.com.
World Journal of Transplantation
|July 11, 2018
Summary
Kidney exchange transplantation significantly boosts living donor kidney transplants by overcoming incompatibilities. Advances include international programs and complex chains, addressing donor travel and anonymity challenges globally.
Area of Science:
- Nephrology
- Transplantation Immunology
- Organ Donation
Background:
- Kidney exchange transplantation is a vital strategy to increase living donor kidney transplants.
- Participants join kidney exchange programs due to ABO, immunological, HLA, chronological, or financial incompatibilities.
- Kidney exchange has evolved from simple 2-way exchanges to complex multi-way, non-simultaneous, and international models.
Purpose of the Study:
- To review recent advancements in kidney exchange transplantation.
- To discuss international kidney exchange, advanced donation programs, and the role of deceased donors.
- To explore issues of donor reneging, anonymity, donor travel versus kidney transport, and global kidney exchange.
Main Methods:
- Literature review of kidney exchange transplantation advancements.
- Discussion of various kidney exchange models, including international and advanced donation programs.
- Analysis of logistical and ethical considerations such as donor travel, anonymity, and deceased donor utilization.
Main Results:
- Kidney exchange transplantation encompasses diverse models, from simple to complex international chains.
- Key considerations include donor travel versus kidney transport and the implications of anonymity.
- Deceased donors can initiate chains, and donor reneging is a factor to consider.
Conclusions:
- Kidney exchange transplantation offers numerous complex models to maximize donor-recipient matching.
- Decisions on donor travel, transport, and anonymity should be consensus-based, considering local resources.
- The future may involve liver versus kidney exchange, especially in resource-limited settings.
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