Loading…
Four-way kidney exchange transplant with desensitization increases access to living-donor kidney transplant: First report from India
Objectives: This study reports our experience of the first 4-way kidney exchange transplant combined with desensitization in India, which allows increased access to living-donor kidney transplant for sensitized patients. Materials and Methods: Four-way kidney exchange transplant procedures were appr...
Saved in:
Published in: | Experimental and clinical transplantation 2018-10, Vol.16 (5), p.528-532 |
---|---|
Main Authors: | , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Objectives: This study reports our experience of the
first 4-way kidney exchange transplant combined
with desensitization in India, which allows increased
access to living-donor kidney transplant for sensitized
patients.
Materials and Methods: Four-way kidney exchange
transplant procedures were approved by the ethics
committee of our institution and the Organ
Transplantation Authorization Committee of state
governments of India (as per the Transplantation of
Human Organs Act of India). The protocols conformed
to Declaration of Istanbul principles and the ethical
guidelines of the 1975 Helsinki Declaration. Written
informed consent was obtained from patients, donors,
and their guardians.
Results: In April 2016, our transplant team completed
simultaneous 4-way kidney exchange transplant pro -
cedures without any medical (rejection and infections)
or surgical complications. Reasons for being included
for kidney exchange transplant were ABO incom -
patible (2 recipients) and sensitization (2 recipients).
All 4 recipients had stable graft function with no
proteinuria and donor-specific antibody at 11-month
follow-up on standard triple immunosup pression.
Patient and graft survival rates were both 100%.
Conclusions: To the best of our knowledge, this is the
first single-center report of 4-way kidney exchange
transplant combined with desensitization from India.
This procedure has the potential to expand livingdonor
kidney transplant in disadvantaged groups (egsensitized patients). Recipients who are hard to match
due to high panel reactive antibody and difficult to
desensitize due to strong donor-specific antibodies
can receive a transplant with a combination of kidney
exchange and desensitization. Our study suggests that
4-way kidney exchange transplant can be performed
in developing countries (India) similar to that shown
in programs in developed countries with team work,
kidney exchange registry, and counseling. |
---|---|
ISSN: | 1304-0855 2146-8427 |
DOI: | 10.6002/ect.2017.0089 |