Scandiatransplant Exchange Program (STEP): Development and Results From an International Kidney Exchange Program

Area of Science:

• Nephrology
• Immunology
• Transplantation Science

Background:

• Kidney transplant candidates often face incompatibility with living donors due to Human Leukocyte Antigen (HLA) and ABO blood group antibodies.
• The Scandiatransplant Exchange Program (STEP) was established in 2019 to address donor-recipient incompatibility and expand living donor options.

Purpose of the Study:

• To evaluate the initial four-year experience of the STEP program.
• To analyze match runs, kidney transplantations performed, and recipient outcomes within the program.

Main Methods:

• Retrospective review of data from the STEP program between 2019 and 2022.
• Analysis of participation in match runs, reasons for incompatibility (HLA and/or ABO), and transplantation success rates.

Main Results:

• 49 kidney transplantations were performed from 2019-2022, with 114 pairs and 6 anonymous donors participating in match runs.
• A significant portion of participants (63%) were listed due to HLA incompatibility.
• 94% of transplant recipients had functioning kidney grafts at follow-up in February 2023.

Conclusions:

• The STEP program successfully expands the donor pool for sensitized patients, facilitating international living donor kidney exchange.
• STEP has become one of the largest transnational kidney exchange programs, improving transplant access for patients within Scandiatransplant.