Temporal trends in kidney paired donation in the United States: 2006-2021 UNOS/OPTN database analysis.

Autor:	Garg N; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. Electronic address: ngarg@medicine.wisc.edu., Thiessen C; Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA., Reese PP; Renal-Electrolyte and Hypertension Division, Department of Medicine, and Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Cooper M; Division of Transplantation, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Leishman R; United Network for Organ Sharing, Richmond, Virginia, USA., Friedewald J; Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Sharfuddin AA; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Nishio Lucar AG; Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA., Dadhania DM; Division of Nephrology, Department of Medicine, Weill Cornell Medicine-New York Presbyterian Hospital, New York, USA., Kumar V; Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA., Waterman AD; Houston Methodist Transplant Center and Academic Institute, Houston, Texas, USA., Mandelbrot DA; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Jazyk:	angličtina
Zdroj:	American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2024 Jan; Vol. 24 (1), pp. 46-56. Date of Electronic Publication: 2023 Sep 20.
DOI:	10.1016/j.ajt.2023.09.006
Abstrakt:	Kidney paired donation (KPD) is a major innovation that is changing the landscape of kidney transplantation in the United States. We used the 2006-2021 United Network for Organ Sharing data to examine trends over time. KPD is increasing, with 1 in 5 living donor kidney transplants (LDKTs) in 2021 facilitated by KPD. The proportion of LDKT performed via KPD was comparable for non-Whites and Whites. An increasing proportion of KPD transplants are going to non-Whites. End-chain recipients are not identified in the database. To what extent these trends reflect how end-chain kidneys are allocated, as opposed to increase in living donation among minorities, remains unclear. Half the LDKT in 2021 in sensitized (panel reactive antibody ≥ 80%) and highly sensitized (panel reactive antibody ≥ 98%) groups occurred via KPD. Yet, the proportion of KPD transplants performed in sensitized recipients has declined since 2013, likely due to changes in the deceased donor allocation policies and newer KPD strategies such as compatible KPD. In 2021, 40% of the programs reported not performing any KPD transplants. Our study highlights the need for understanding barriers to pursuing and expanding KPD at the center level and the need for more detailed and accurate data collection at the national level. (Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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