Dynamic challenges inhibiting optimal adoption of kidney paired donation: findings of a consensus conference

M L Melcher; C D Blosser; L A Baxter-Lowe; F L Delmonico; S E Gentry; R Leishman; G A Knoll; M S Leffell; A B Leichtman; D A Mast; P W Nickerson; E F Reed; M A Rees; J R Rodrigue; D L Segev; D Serur; S G Tullius; E Y Zavala; S Feng

doi:10.1111/ajt.12140

Dynamic challenges inhibiting optimal adoption of kidney paired donation: findings of a consensus conference

Am J Transplant. 2013 Apr;13(4):851-860. doi: 10.1111/ajt.12140. Epub 2013 Feb 7.

Authors

M L Melcher¹, C D Blosser², L A Baxter-Lowe³, F L Delmonico^{4

5}, S E Gentry⁶, R Leishman⁷, G A Knoll⁸, M S Leffell⁹, A B Leichtman¹⁰, D A Mast¹¹, P W Nickerson¹², E F Reed¹³, M A Rees¹⁴, J R Rodrigue¹⁵, D L Segev¹⁶, D Serur¹⁷, S G Tullius¹⁸, E Y Zavala¹⁹, S Feng³

Affiliations

¹ Department of Surgery, Stanford University, Stanford, CA.
² Department of Internal Medicine, University of Iowa, Iowa City, IA.
³ Department of Surgery, UCSF, San Francisco, CA.
⁴ Department of Surgery, Massachusetts General Hospital, Boston, MA.
⁵ New England Organ Bank, Boston, MA.
⁶ Department of Mathematics, U.S. Naval Academy, Annapolis, MD.
⁷ United Network of Organ Sharing, Richmond, VA.
⁸ Department of Medicine, Ottawa Hospital, Ottawa, ON.
⁹ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
¹⁰ Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
¹¹ Stanford Hospital and Clinics, Palo Alto, CA.
¹² Department of Internal Medicine, University of Manitoba, Winnipeg, MB.
¹³ Department of Pathology, University of California Los Angeles, Los Angeles, CA.
¹⁴ Department of Urology & Pathology, University of Toledo Medical Center, Toledo, OH.
¹⁵ Transplant Institute, Beth Israel Deaconess Medical School, Boston, MA.
¹⁶ Department of Surgery, Johns Hopkins University, Baltimore, MD.
¹⁷ Department of Surgery, Cornell University, New York, NY.
¹⁸ Department of Surgery, Brigham & Women's Hospital Harvard University, Boston, MA.
¹⁹ Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.

PMID: 23398969
DOI: 10.1111/ajt.12140

Abstract

While kidney paired donation (KPD) enables the utilization of living donor kidneys from healthy and willing donors incompatible with their intended recipients, the strategy poses complex challenges that have limited its adoption in United States and Canada. A consensus conference was convened March 29-30, 2012 to address the dynamic challenges and complexities of KPD that inhibit optimal implementation. Stakeholders considered donor evaluation and care, histocompatibility testing, allocation algorithms, financing, geographic challenges and implementation strategies with the goal to safely maximize KPD at every transplant center. Best practices, knowledge gaps and research goals were identified and summarized in this document.

Publication types

Congress

MeSH terms

Algorithms
Canada
Donor Selection / methods*
Histocompatibility Testing
Humans
Kidney Transplantation / methods*
Living Donors*
Renal Insufficiency / therapy*
United States

Grants and funding

R18 HS020610/HS/AHRQ HHS/United States