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Voucher-Based Kidney Donation and Redemption for Future Transplant
Jeffrey L Veale1, Nima Nassiri2, Alexander M Capron2,3
1Kidney Transplant Exchange Program, UCLA Health, Department of Urology, David Geffen School of Medicine at ULCA, University of California, Los Angeles, Los Angeles.
JAMA Surgery
|June 23, 2021
Summary
Kidney transplant voucher programs encourage living donation by allowing future transplants. These programs facilitated 573 transplants, with voucher redemptions providing timely kidney allografts for recipients.
Area of Science:
- Nephrology
- Transplant Surgery
- Organ Donation
Background:
- Increasing kidney transplants requires facilitating living donation.
- Vouchers for future transplants address chronological incompatibility in donation timing.
- Uncertainty exists regarding voucher program impact on donor numbers and timely transplants.
Purpose of the Study:
- Examine consequences of voucher-based kidney donation.
- Assess capability of voucher redemptions for timely kidney allografts.
Main Methods:
- Multicenter cohort study (79 US transplant centers).
- Data from National Kidney Registry (Jan 2014-Jan 2021).
- Analysis of family vouchers and downstream kidney-paired donations.
Main Results:
- 250 family voucher-based donations facilitated, leading to 573 total transplants.
- 19.4% of transplants were for highly sensitized recipients.
- Waiting time in the exchange pool decreased by over 3 months; 6 vouchers redeemed timely.
Conclusions:
- Family voucher programs mitigate disincentives for living kidney donation.
- Facilitated donations may not have otherwise occurred.
- Redeemed vouchers successfully provided timely kidney transplants.
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