TY - JOUR
T1 - Kidney exchange strategies
T2 - new aspects and applications with a focus on deceased donor-initiated chains
AU - Furian, Lucrezia
AU - Nicolò, Antonio
AU - Di Bella, Caterina
AU - Cardillo, Massimo
AU - Cozzi, Emanuele
AU - Rigotti, Paolo
N1 - Funding Information:
This work was supported by Progetti Strategici di Ateneo – bando 2011, University of Padova: ‘Kidney – Incorporating patients’ preferences in kidney transplant decision protocols’.
Publisher Copyright:
© 2020 Steunstichting ESOT. Published by John Wiley & Sons Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Kidney paired donation (KPD) is a valuable way to overcome immunological incompatibility in the context of living donation, and several strategies have been implemented to boost its development. In this article, we reviewed the current state of the art in this field, with a particular focus on advanced KPD strategies, including the most recent idea of initiating living donor (LD) transplantation chains with a deceased donor (DD) kidney, first applied successfully in 2018. Since then, Italy has been running a national programme in which a chain-initiating kidney is selected from a DD pool and allocated to a recipient with an incompatible LD, and the LD’s kidney is transplanted into a patient on the waiting list (WL). At this stage, since the ethical and logistic issues have been managed appropriately, KPD starting with a DD has proved to be a feasible strategy. It enables transplants in recipients of incompatible pairs without the need for desensitizing and also benefits patients on the WL who are allocated chain-ending kidneys from LDs (prioritizing sensitized patients and those on the WL for longer).
AB - Kidney paired donation (KPD) is a valuable way to overcome immunological incompatibility in the context of living donation, and several strategies have been implemented to boost its development. In this article, we reviewed the current state of the art in this field, with a particular focus on advanced KPD strategies, including the most recent idea of initiating living donor (LD) transplantation chains with a deceased donor (DD) kidney, first applied successfully in 2018. Since then, Italy has been running a national programme in which a chain-initiating kidney is selected from a DD pool and allocated to a recipient with an incompatible LD, and the LD’s kidney is transplanted into a patient on the waiting list (WL). At this stage, since the ethical and logistic issues have been managed appropriately, KPD starting with a DD has proved to be a feasible strategy. It enables transplants in recipients of incompatible pairs without the need for desensitizing and also benefits patients on the WL who are allocated chain-ending kidneys from LDs (prioritizing sensitized patients and those on the WL for longer).
KW - advanced kidney paired donation
KW - deceased donor-initiated domino chains
KW - domino-paired chains
KW - incompatible pairs
KW - living kidney donor
UR - http://www.scopus.com/inward/record.url?scp=85090124577&partnerID=8YFLogxK
U2 - 10.1111/tri.13712
DO - 10.1111/tri.13712
M3 - Review article
C2 - 32772429
AN - SCOPUS:85090124577
SN - 0934-0874
VL - 33
SP - 1177
EP - 1184
JO - Transplant International
JF - Transplant International
IS - 10
ER -