The Development of a Successful Multiregional Kidney Paired Donation Program
| Autor: | William Reitsma, Francis L. Delmonico, Ruthanne L. Hanto |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Tissue and Organ Procurement Waiting Lists Kidney Paired Donation Kidney Living donor Regional Health Planning ABO Blood-Group System New england HLA Antigens New England Living Donors medicine Humans Operations management Registries Organ donation Transplantation business.industry Histocompatibility Testing Kidney Transplantation Human leukocyte antigen antibody Histocompatibility Surgery Blood Group Incompatibility Donation business Software |
| Zdroj: | Transplantation. 86:1744-1748 |
| ISSN: | 0041-1337 |
| Popis: | Background. Kidney paired donation (KPD) is increasing the number of living donor transplants. Two major obstacles prevent moving KPD forward in the United States: (1) achieving a critical mass of pairs to efficiently find matches and (2) efficiently coordinating KPD transplants between multiple transplant centers. Two large regional programs, The New England Program for Kidney Exchange (NEPKE) and the Mid-Atlantic Paired Exchange Program (MAPEP) have developed a system of protocols to effectively increase the number of KPD transplants. Methods. Incompatible pairs and nondirected donors (NDD) are referred to the system through transplant centers. Donor and recipient ABO, human leukocyte antigen, and recipient human leukocyte antigen antibody screening are used to determine potential matches. Utilization of a computer optimization algorithm matches pairs in two- and three-way exchanges, NDD chains, and list exchange chains. Team conference calls regarding transfer of information, crossmatches, surgery date, coordination of simultaneous donor nephrectomies, and other issues are coordinated as needed. Results. Ten matches moved forward to donation and transplantation, and one is pending. Eight of these matches involved NDD chains, two 2-way exchanges, and 1 a list exchange chain. These matches resulted in 27 transplants. Eighteen transplants occurred in NEPKE-only transplant centers, four in MAPEP-only centers, and an additional five were crossregional. Conclusion. The collaboration of NEPKE and MAPEP has demonstrated that crossregional coordination is feasible and expands the number of transplants performed beyond the capability of either program alone, especially when combined with computer optimization and multiple-type matches of three-way, NDD chains, and list exchange chains. |
| Databáze: | OpenAIRE |
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