Abstract: TH-PO1178
Non-Simultaneous Kidney Exchange Cycles in Resource-Restricted Countries Without Nondirected Donation
Session Information
- Transplantation: Clinical - Pretransplant Management
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Patel, Himanshu V., IKDRC-ITS, Ahmedabad, India
- Patel, Ansy Himanshu, BJ Medical College, Ahmedabad, India
- Kute, Vivek Balkrishna, IKDRC-ITS, Ahmedabad, India
Background
Recent reports suggest that bridge donor renege is rare (1.5%) as part of non-simultaneous kidney exchange chains. In developing countries, surgical space and resources limit the number of simultaneous kidney exchange transplant surgeries.
Methods
The aim of this study was to evaluate the bridge donor renege rate during non-simultaneous kidney exchange cycles in a prospective single center cohort study (n=44). We describe the protocol to prepare donor-recipient pairs for non-simultaneous surgeries designed to reduce the renege rate. We propose using standard criteria deceased donor kidneys in the event of a bridge donor renege to protect vulnerable recipients
Results
We report 12 successful non-simultaneous kidney exchange cycles resulting in 44 living donor kidney transplants. These cycles involved 16 bridge donors who were trusted to donate after their incompatible recipient was transplanted, placing 15 recipients at risk (two were at risk from two bridge donors), and no donor reneged. We propose that non-simultaneous kidney exchange cycles could increase living donor kidney transplantation, especially for difficult to match sensitized pairs (17 of 44), in countries with limited transplantation resources
Conclusion
Our study confirms that non-simultaneous kidney exchange cycles can be safely performed with careful patient-donor selection and non-anonymous kidney exchange.