Asynchronous, Out‐of‐Sequence, Transcontinental Chain Kidney Transplantation: A Novel Concept

@article{Butt2009AsynchronousOT,
  title={Asynchronous, Out‐of‐Sequence, Transcontinental Chain Kidney Transplantation: A Novel Concept},
  author={Fauzia K. Butt and H A Gritsch and Peter G. Schulam and Gabriel Danovitch and Alan H. Wilkinson and Joseph J. Del Pizzo and Sandip Kapur and David Serur and Steven Katznelson and Stephan Busque and Marc L. Melcher and Suzanne McGuire and Marian Charlton and Garet Hil and Jeffrey L. Veale},
  journal={American Journal of Transplantation},
  year={2009},
  volume={9}
}
The organ donor shortage has been the most important hindrance in getting listed patients transplanted. Living kidney donors who are incompatible with their intended recipients are an untapped resource for expanding the donor pool through participation in transplant exchanges. Chain transplantation takes this concept further, with the potential to benefit even more recipients. We describe the first asynchronous, out of sequence transplant chain that was initiated by transcontinental shipment of… 
View on Wiley
onlinelibrary.wiley.com
56 Citations
Highly Influential Citations
1
Background Citations
21
Results Citations
1

56 Citations

Kidney paired donation: advancements and future directions
TLDR
Kidney paired donation has become a viable option for patients in need of a kidney transplant who have a willing, but incompatible living donor and it has become more apparent that KPD can be successfully combined with desensitization in order to transplant the authors' most immunologically challenging patients.
Paired kidney exchange transplantation – pushing the boundaries
  • V. Kher, P. Jha
  • Medicine
    Transplant international : official journal of the European Society for Organ Transplantation
  • 2020
TLDR
An in‐depth analysis of the evolution, the present global scenario, and the future of PKE is provided and the recent trends of advanced donation, trans‐organ paired exchange and global kidney exchange are discussed.
The Incorporation of an Advanced Donation Program Into Kidney Paired Exchange: Initial Experience of the National Kidney Registry
  • S. Flechner, D. Leeser, G. Hil
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2015
TLDR
The Advanced Donation Program (ADP) is a viable method to support time limited donors in a KPD network in which the donor desires to donate by a specific date, but their paired recipient has not yet been matched to a specific donor or scheduled for surgery.
The application of paired donation to live donor liver transplantation
  • D. Segev, R. Montgomery
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2010
The last decade has seen substantial growth and expansion of kidney paired donation (KPD), a modality by which pairs of incompatible live kidney donors and their intended recipients exchange kidneys…
Kidney paired donation: fundamentals, limitations, and expansions.
TLDR
This review article details how several impediments to Kidney paired donation have been overcome to the benefit of ever greater numbers of patients.
Innovative strategies in living donor kidney transplantation
  • D. Segev
  • Medicine
    Nature Reviews Nephrology
  • 2012
TLDR
ABO-in incompatible transplantation can now be successfully performed without high-intensity immunomodulation, and HLA-incompatible transplantation has been shown in a large single-center study to provide profound survival benefit compared with waiting for a compatible donor.
Advanced Donation Programs and Deceased Donor-Initiated Chains—2 Innovations in Kidney Paired Donation
TLDR
An outline of ethical issues raised by advanced donation, deceased donor initiated chains, and use of deceased donors for chain-initiating kidneys is outlined and discussed so that these KPD innovations programs are ultimately successful.
Allocation and matching in kidney exchange programs
TLDR
Challenges include making full use of the various modalities that are now available through integrated and optimized matching software, encouragement of transplant centers to fully participate, improving transplant rates by focusing on the expected long‐run number of transplants, and selecting uniform allocation criteria to facilitate international pools.
Outcomes of paired-exchange live-donor kidney transplantation: a single-center experience.
Living donor kidney paired donation transplantation: experience as a founding member center of the National Kidney Registry
TLDR
KPD involving participation of multiple transplant centers can provide opportunities for transplantation, with potential to expand the donor pool, minimize waiting times, and enable pre‐emptive transplantation.
...
...

References

SHOWING 1-10 OF 26 REFERENCES
Exchange donor program in kidney transplantation.
TLDR
Living donors including related, unrelated, and exchange donors should be considered as potential donors for kidney transplantation to relieve the pressure on donor organ shortage in countries where brain death has not been socially or legally accepted.
Exchange living-donor kidney transplantation: diminution of donor organ shortage.
Successful Three‐Way Kidney Paired Donation with Cross‐Country Live Donor Allograft Transport
  • R. Montgomery, S. Katznelson, D. Segev
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2008
TLDR
This case provides a blueprint for solving some of the complexities that are inherent in the implementation of a national KPD program in a large country like the United States.
The Dutch National Living Donor Kidney Exchange Program
TLDR
The living donor kidney exchange program is a successful approach that does not harm any of the candidates on the deceased donor kidney waitlist and should be sustained for optimal results.
Clinical results from transplanting incompatible live kidney donor/recipient pairs using kidney paired donation.
TLDR
This series of patients who received transplants from a single-center KPD pool provides evidence that recipients with incompatible live donors, even those with rare blood type combinations or high degrees of HLA antigen sensitization, can receive transplants through KPD with graft survival rates that appear to be equivalent to directed, compatible live donor transplants.
Domino paired kidney donation: a strategy to make best use of live non-directed donation
Kidney paired donation and optimizing the use of live donor organs.
TLDR
The combination of a national KPD program and a mathematically optimized matching algorithm yields more matches with lower HLA disparity, and the health care system could save as much as $750 million.
The importance of innovative efforts to increase organ donation.
TLDR
The number of candidates annually on the waiting list for a deceased donor transplant has exceeded the number of available kidneys and waiting time has steadily lengthened, resulting in a small increase in deceased donor transplants in the United States in the last 2 years.
Cold Ischemia Time and Allograft Outcomes in Live Donor Renal Transplantation: Is Live Donor Organ Transport Feasible?
  • C. Simpkins, R. Montgomery, D. Segev
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2007
TLDR
Comparable long‐term outcomes for these grafts suggests that transport of live donor organs may be a feasible alternative to donor travel in KPD regions where CIT can be limited to 8 h.
A nonsimultaneous, extended, altruistic-donor chain.
TLDR
A chain of 10 kidney transplantations, initiated in July 2007 by a single altruistic donor and coordinated over a period of 8 months by two large paired-donation registries, illustrates the potential of this strategy.
...
...