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Br J Surg. 2007 Jun;94(6):657-64.

Paired exchange programmes can expand the live kidney donor pool.

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  • 1Renal Transplantation Unit, Royal Free Hospital and University College London Medical School, Pond Street, London NW3 2QG, UK.

Abstract

BACKGROUND:

Kidney paired donation (KPD) is an exchange of organs between two live donors, who are otherwise ABO incompatible or cross-match positive, and their intended recipients. The outcome is the generation of compatible transplants conferring an improvement in quality of life and longevity.

METHODS:

Medline was searched for articles on KPD using a combination of keywords. Publications focusing on protocols and policy, mathematical modelling, ethical controversies, and legal and logistical barriers were identified.

RESULTS:

Many are precluded from transplantation because of incompatibilities with their intended donors. KPD has the potential to increase the rate of transplantation by facilitating exchange transplants between otherwise incompatible donor-recipient couples. Ethical controversies surrounding paired donation include confidentiality, conditionality of donation, synchronicity of operations and the possibility of disadvantaging blood group O recipients. Logistical barriers hampering KPD programmes involve the location of donor surgery and organ transport.

CONCLUSION:

Paired donation may expand the living donor pool by providing an alternative successful strategy for incompatible donor-recipient couples. Its widespread implementation will depend on resolving ethical and logistical constraints.

(c) 2007 British Journal of Surgery Society Ltd.

[PubMed - indexed for MEDLINE]
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