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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 25  |  Issue : 6  |  Page : 349-354

Paired kidney exchange transplantation: Maximizing the donor pool


1 Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India
2 Lab Medicine, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India
3 Department of Urology, Medanta Institute of Kidney and Urology, Medanta-The Medicity, Gurgaon, Haryana, India

Correspondence Address:
P K Jha
Department of Nephrology, Medanta Kidney and Urology Institute, Medanta-The Medicity, Gurgaon - 122 018, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.150721

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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.






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Indian Journal of Nephrology
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Online since 20th Sept '07