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Paired kidney exchange transplantation: Maximizing the donor pool.

Jha PK, Sethi S, Bansal SB, Jain M, Sharma R, Phanish MK, Duggal R, Ahlawat R, Kher V - Indian J Nephrol (2015 Nov-Dec)

Bottom Line: PKE patients had significantly higher number of HLA mismatches (5.03 ± 1.14 vs. 3.49 ± 1.57; P < 0.0001).After a median follow-up of 20 months (range: 3-47 months), there was no significant difference in patient survival (PKE 96.16% vs. non-PKE 96.65%; P = 0.596) and death censored graft survival (PKE 96.16% vs. non-PKE 96.37%; P = 1).To conclude, paired kidney donation is an excellent way of increasing the donor pool and needs to be promoted to overcome the shortage of suitable kidney in our country.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India.

ABSTRACT
In the last decade, paired kidney exchange (PKE) transplantation has gained popularity worldwide as a viable alternative for end stage renal disease (ESRD) patients who have incompatible or sensitized donors. This study presents our experience with PKE transplantation and compares outcome between PKE and non-PKE renal transplant recipients. Between February 2010 and November 2013, 742 transplants were performed, of which 26 (3.5%) were PKE transplantations. All were two-way exchanges. PKE recipients were significantly older than non-PKE (46.73 ± 9.71 vs. 40.08 ± 13.36 years; P = 0.012) while donor ages were comparable. PKE patients had significantly higher number of HLA mismatches (5.03 ± 1.14 vs. 3.49 ± 1.57; P < 0.0001). After a median follow-up of 20 months (range: 3-47 months), there was no significant difference in patient survival (PKE 96.16% vs. non-PKE 96.65%; P = 0.596) and death censored graft survival (PKE 96.16% vs. non-PKE 96.37%; P = 1). Mean serum creatinine at 1 month and at last follow-up was lower in PKE versus non-PKE group (0.98 ± 0.33 vs. 1.3 ± 0.61 mg/dl; P = 0.008 and 0.96 ± 0.30 vs. 1.27 ± 0.57 mg/dl, P = 0.006, respectively). Biopsy proven acute rejection rate was 11.5% in PKE group and 16.89% in non-PKE patients (P = 0.6). To conclude, paired kidney donation is an excellent way of increasing the donor pool and needs to be promoted to overcome the shortage of suitable kidney in our country.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier graph comparing death censored graft survival between PKE group and non-PKE group patients
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Figure 2: Kaplan-Meier graph comparing death censored graft survival between PKE group and non-PKE group patients

Mentions: Figures 1 and 2 show Kaplan–Meier curves comparing patient survival and death censored graft survival between the study groups, respectively.


Paired kidney exchange transplantation: Maximizing the donor pool.

Jha PK, Sethi S, Bansal SB, Jain M, Sharma R, Phanish MK, Duggal R, Ahlawat R, Kher V - Indian J Nephrol (2015 Nov-Dec)

Kaplan-Meier graph comparing death censored graft survival between PKE group and non-PKE group patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663772&req=5

Figure 2: Kaplan-Meier graph comparing death censored graft survival between PKE group and non-PKE group patients
Mentions: Figures 1 and 2 show Kaplan–Meier curves comparing patient survival and death censored graft survival between the study groups, respectively.

Bottom Line: PKE patients had significantly higher number of HLA mismatches (5.03 ± 1.14 vs. 3.49 ± 1.57; P < 0.0001).After a median follow-up of 20 months (range: 3-47 months), there was no significant difference in patient survival (PKE 96.16% vs. non-PKE 96.65%; P = 0.596) and death censored graft survival (PKE 96.16% vs. non-PKE 96.37%; P = 1).To conclude, paired kidney donation is an excellent way of increasing the donor pool and needs to be promoted to overcome the shortage of suitable kidney in our country.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India.

ABSTRACT
In the last decade, paired kidney exchange (PKE) transplantation has gained popularity worldwide as a viable alternative for end stage renal disease (ESRD) patients who have incompatible or sensitized donors. This study presents our experience with PKE transplantation and compares outcome between PKE and non-PKE renal transplant recipients. Between February 2010 and November 2013, 742 transplants were performed, of which 26 (3.5%) were PKE transplantations. All were two-way exchanges. PKE recipients were significantly older than non-PKE (46.73 ± 9.71 vs. 40.08 ± 13.36 years; P = 0.012) while donor ages were comparable. PKE patients had significantly higher number of HLA mismatches (5.03 ± 1.14 vs. 3.49 ± 1.57; P < 0.0001). After a median follow-up of 20 months (range: 3-47 months), there was no significant difference in patient survival (PKE 96.16% vs. non-PKE 96.65%; P = 0.596) and death censored graft survival (PKE 96.16% vs. non-PKE 96.37%; P = 1). Mean serum creatinine at 1 month and at last follow-up was lower in PKE versus non-PKE group (0.98 ± 0.33 vs. 1.3 ± 0.61 mg/dl; P = 0.008 and 0.96 ± 0.30 vs. 1.27 ± 0.57 mg/dl, P = 0.006, respectively). Biopsy proven acute rejection rate was 11.5% in PKE group and 16.89% in non-PKE patients (P = 0.6). To conclude, paired kidney donation is an excellent way of increasing the donor pool and needs to be promoted to overcome the shortage of suitable kidney in our country.

No MeSH data available.


Related in: MedlinePlus