TY - JOUR
T1 - The first 9 years of kidney paired donation through the National Kidney Registry
T2 - Characteristics of donors and recipients compared with National Live Donor Transplant Registries
AU - Flechner, Stuart M.
AU - Thomas, Alvin G.
AU - Ronin, Matthew
AU - Veale, Jeffrey L.
AU - Leeser, David B.
AU - Kapur, Sandip
AU - Peipert, John D.
AU - Segev, Dorry L.
AU - Henderson, Macey L.
AU - Shaffer, Ashton A.
AU - Cooper, Matthew
AU - Hil, Garet
AU - Waterman, Amy D.
N1 - Publisher Copyright:
© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2018/11
Y1 - 2018/11
N2 - The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.
AB - The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.
KW - clinical research/practice
KW - donors and donation: living
KW - donors and donation: paired exchange
KW - kidney transplantation/nephrology
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U2 - 10.1111/ajt.14744
DO - 10.1111/ajt.14744
M3 - Article
C2 - 29603640
AN - SCOPUS:85046109428
SN - 1600-6135
VL - 18
SP - 2730
EP - 2738
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 11
ER -