Transplantation 07/2010; 90. DOI:10.1097/00007890-201007272-01064 · 3.83 Impact Factor
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ABSTRACT: Altruistic unbalanced paired kidney exchanges (AUPKE) use compatible live donor/recipient pairs to facilitate transplants for individuals with incompatible live donors. We report a three donor/recipient pair complex AUPKE. Little is known of the circumstances under which individuals are likely to trade away a compatible live donor or the overall impact that AUPKE could have on the organ supply.
(1) A retrospective analysis of live donor renal transplants was performed using United Network for Organ Sharing data and our own center experience to determine the potential impact of AUPKE. (2) At initial evaluation, potential donors and recipients were administered a survey regarding attitudes toward AUPKE using a 5-point Likert Scale.
(1) One thousand three hundred ninety-six (22.8%) ABO compatible but nonidentical live donor transplants were performed in the United States in 2005. Ninety-one percent of donors were blood group O. (2) Recipient survey respondents were more likely than donors (P=0.002) to favor participation in AUPKE with no advantage to themselves. A number of circumstances increased the propensity to view AUPKE favorably (P<0.05).
(1) AUPKE can have a profound impact on the kidney supply. (2) By using ABO compatible but nonidentical donors, AUPKE can be performed at individual centers without requiring large sharing networks. (3) O recipients with incompatible donors are likely to be the primary beneficiary of AUPKE. (4) Attitudes are not static and can be influenced in favor of participation if there is a perceived benefit to the recipient. (5) Both donors and recipients are more willing to participate if their intended recipient or donor is enthusiastic about participating. (6) AUPKE reflects a paradigm shift for live donation, converting a private resource (the donor) to a shared one.
Transplantation 01/2010; 89(1):15-22. DOI:10.1097/TP.0b013e3181c626e1 · 3.83 Impact Factor
Transplantation 07/2008; 86(Supplement). DOI:10.1097/01.tp.0000332345.01702.0e · 3.83 Impact Factor
Transplantation 07/2008; 86(Supplement). DOI:10.1097/01.tp.0000332740.35862.86 · 3.83 Impact Factor
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ABSTRACT: Paired kidney exchanges are being used with increasing frequency to overcome humoral immunologic incompatibilities between patients in need of renal transplantation and their potential live donors. Altruistic unbalanced exchanges utilize compatible donor/recipient pairs in order to facilitate the transplantation of a patient with an incompatible donor. We have now performed several altruistic unbalanced paired kidney exchanges at our institution. Also, we have surveyed potential donors and recipients regarding their attitudes toward participating in altruistic unbalanced paired kidney exchanges. Patients are most amenable to participation if they perceive a benefit from trading away a compatible donor. Given the number of compatible live donor transplants performed annually, if practiced on a broad scale, altruistic unbalancedpaired kidney exchanges can have a profound impact upon the supply of kidneys for transplantation. These exchanges can be performed at individual centers without the requirement for largesharing pools or complex computer algorithms. However, there are a number of ethical and logistical considerations that must be addressed. Altruistic unbalanced paired kidney exchanges represent a major paradigm shift in renal transplantation, in that a private resource (i.e. the live kidney donor) is converted to a shared or public one.
Clinical transplants 02/2008;