Journal
AMERICAN JOURNAL OF KIDNEY DISEASES
Volume 57, Issue 1, Pages 144-151Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ajkd.2010.10.005
Keywords
Kidney exchange; paired donation; incompatible; matching; altruistic donor; good Samaritan donor; nondirected donor; nonsimultaneous extended altruistic donor chain; bridge donor; list-paired donation
Categories
Funding
- National Kidney Foundation of Maryland
- American Society of Transplantation
- National Institute of Diabetes and Digestive and Kidney Diseases [RC1DK086731]
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [RC1DK086731] Funding Source: NIH RePORTER
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Incompatibility between the candidate recipient and the prospective donor is a major obstacle to living donor kidney transplant. Kidney paired donation (KPD) can circumvent the incompatibility by matching them to another candidate and living donor for an exchange of transplants such that both transplants are compatible. KPD has faced legal, logistical, and ethical challenges since its inception in the 1980s. Although the full potential of this modality for facilitating transplant for individuals with incompatible donors is unrealized, great strides have been made. In this review article, we detail how several impediments to KPD have been overcome to the benefit of ever greater numbers of patients. Limitations and questions that have been addressed include blood group type O imbalance, reciprocal match requirements, simultaneous donor nephrectomy requirements, combining KPD with desensitization, the role of list-paired donation, geographic barriers, legal barriers, concerns regarding living donor safety, fragmented registries, and inefficient matching algorithms. Am J Kidney Dis. 57(1): 144-151. (C) 2010 by the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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