Building Kidney Exchange Programmes in Europe-An Overview of Exchange Practice and Activities.

Area of Science:

• Nephrology
• Transplantation
• Health Services Research

Background:

• Significant variations exist in European living donor Kidney Exchange Programmes (KEPs).
• Limited exchange of best practices and approaches among European KEPs hinders progress.
• This variation impacts the number of living donor kidney transplants performed across Europe.

Purpose of the Study:

• To gather detailed information on the functioning, opportunities, and challenges of all existing KEPs in Europe.
• To conduct a comparative analysis of KEPs across European countries.
• To identify common and unique challenges faced by KEPs in different national contexts.

Main Methods:

• A questionnaire was developed and administered by experts from 23 European countries.
• Data on KEP operations, opportunities, and challenges were collected.
• Results were synthesized and interpreted through comparative analysis by the collaborating experts.

Main Results:

• Seventeen European countries reported on their KEPs, revealing varying stages of program maturity.
• Over 1300 kidney transplants were performed via KEPs by the end of 2016, constituting ~8% of living kidney donations in 2015.
• Challenges in initiating or expanding KEPs are common, influenced by national context and ethical/legal factors; transnational initiatives are emerging.

Conclusions:

• Sharing best practices and advancing national programs through transnational collaboration can improve KEP effectiveness.
• Addressing existing challenges via shared strategies may significantly enhance access to kidney transplantation.
• Improved KEPs offer a cost-effective treatment option for the growing population with kidney disease.