Kidney paired donation is an excellent option for transplant candidates

January 28, 2020

HighlightsWashington, DC (January 28, 2020) -- Recipients of kidney paired donation through a national program, also called kidney exchange, experience equivalent outcomes when compared with all other living donor kidney transplant recipients, according to a recent analysis. The findings, which appear in an upcoming issue of CJASN, are reassuring that a national kidney paired donation program is a safe and effective way to treat patients with incompatible living donors.

In kidney paired donation, living donor kidneys are swapped so that each recipient receives a compatible transplant. David B. Leeser, MD (East Carolina University Brody School of Medicine) and his colleagues compared the outcomes of recipients who received kidneys in this way to "control" recipients who received kidneys from other living donors (such as relatives, friends or other paired exchange mechanisms).

The analysis included 2,363 recipients who received kidneys from the National Kidney Registry, the largest program for kidney paired donation in the world, and 54,497 control recipients. Recipients in the two groups had similar rates of organ failure (5-6%) and mortality (9-10%) over a median follow-up of 3.7 years, with a maximum follow-up of 11 years.

"The study shows that patients can expect equivalent to better outcomes by using the National Kidney Registry. In the future, the transplant community may start to see living donors as a national or community resource that should be shared," said Dr. Leeser. "The result could be the ability to transplant hard to match recipients and even better matching of easy to match recipients. Since organ availability is the limiting factor in kidney transplantation nationwide, the ability to perform kidney transplants with a greater likelihood of surviving for longer periods of time is an imperative that will decrease the number of patients being placed on the waiting list for retransplant."

An accompanying editorial notes that if the early success of the National Kidney Registry is sustained, it may be the program of choice for participation. "The NKR has led the way in technology and innovation, and outcomes demonstrate success for those classically disadvantaged for living donor transplant, including black recipients and those who are highly sensitized," the authors wrote. "The current report on ten years of transplantation in a national paired donor program is encouraging, and may convince more transplant programs to 'buy in' to the National Kidney Registry."
-end-
Study co-authors include Alvin G. Thomas, MSPH, Ashton A. Shaffer, BA, Jeffrey L. Veale, MD, Allan B. Massie, PhD, MHS, Matthew Cooper, MD, Sandip Kapur, Nicole Turgeon, Dorry L. Segev, MD, PhD, Amy D. Waterman, PhD, and Stuart M. Flechner, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Excellent Outcomes with Challenging Patients: 10 Year Outcomes in the National Kidney Registry," will appear online at http://cjasn.asnjournals.org/ on January 28, 2020, doi: 10.2215/CJN.06660619.

The editorial, entitled "The National Kidney Registry: Time to Buy In?" will appear online at http://cjasn.asnjournals.org/ on January 28, 2020, doi: 10.2215/CJN.14581119.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.Since 1966, the American Society of Nephrology (ASN) has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, visit http://www.asn-online.org.

American Society of Nephrology

Related Mortality Articles from Brightsurf:

Being in treatment with statins reduces COVID-19 mortality by 22% to 25%
A research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by LluĂ­s Masana has found that people who are being treated with statins have a 22% to 25% lower risk of dying from COVID-19.

Mortality rate higher for US rural residents
A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

COVID-19, excess all-cause mortality in US, 18 comparison countries
COVID-19 deaths and excess all-cause mortality in the U.S. are compared with 18 countries with diverse COVID-19 responses in this study.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin
A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality.

Hydroxychloroquine reduces in-hospital COVID-19 mortality
An Italian observational study contributes to the ongoing debate regarding the use of hydroxychloroquine in the current pandemic.

What's the best way to estimate and track COVID-19 mortality?
When used correctly, the symptomatic case fatality ratio (sCFR) and the infection fatality ratio (IFR) are better measures by which to monitor COVID-19 epidemics than the commonly reported case fatality ratio (CFR), according to a new study published this week in PLOS Medicine by Anthony Hauser of the University of Bern, Switzerland, and colleagues.

COVID-19: Bacteriophage could decrease mortality
Bacteriophage can reduce bacterial growth in the lungs, limiting fluid build-up.

COPD and smoking associated with higher COVID-19 mortality
Current smokers and people with chronic obstructive pulmonary disease (COPD) have an increased risk of severe complications and higher mortality with COVID-19 infection, according to a new study published May 11, 2020 in the open-access journal PLOS ONE by Jaber Alqahtani of University College London, UK, and colleagues.

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.

Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.

Read More: Mortality News and Mortality Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.