Expanding Kidney Paired Donation Through Participation By Compatible Pairs

American Journal of Transplantation, Vol. 7, No. 10, pp. 2361-2370, 2007

Posted: 6 Jun 2007 Last revised: 20 Oct 2007

See all articles by Dorry Segev

Dorry Segev

affiliation not provided to SSRN

Sommer Gentry

Johns Hopkins University - Johns Hopkins Medical Institutions

Mary Simmerling

Adler University; Cornell University, Weill Cornell Medical College

Robert Montgomery

Johns Hopkins University - Johns Hopkins Medical Institutions

Abstract

In kidney paired donation (KPD), incompatible pairs exchange kidneys so that each recipient receives a compatible organ. This modality is underutilized partly because of the difficulty of finding a suitable match among incompatible pairs. Alternatively, recipients with compatible donors might enter KPD arrangements in order to be matched with a donor predicted to give greater allograft durability or for other altruistic reasons. Using simulated donors and recipients, we investigated the impact of allowing recipients and their compatible donors to participate in KPD. For KPD programs of any size, the participation of compatible donor/recipient pairs nearly doubled the match rate for incompatible pairs (28.2% to 64.5% for single-center program, 37.4% to 75.4% for national program). Legal, logistical, and governmental controversies have hampered the expansion of KPD in the United States by delaying the creation of a national program. The inclusion of compatible pairs into small single-center pools could achieve match rates that would surpass that which could be realized by a national list made up of only incompatible pairs. This new paradigm of KPD can immediately be instituted at the singlecenter level, while the greatest gains will be achieved by incorporating compatible pairs into a national program.

Keywords: paired kidney exchange, live donor kidney transplantation, donor exchange, incompatible donors, blood type incompatibility, altruistically unbalanced exchange

Suggested Citation

Segev, Dorry and Gentry, Sommer and Simmerling, Mary and Montgomery, Robert, Expanding Kidney Paired Donation Through Participation By Compatible Pairs. American Journal of Transplantation, Vol. 7, No. 10, pp. 2361-2370, 2007, Available at SSRN: https://ssrn.com/abstract=991353

Dorry Segev (Contact Author)

affiliation not provided to SSRN

Sommer Gentry

Johns Hopkins University - Johns Hopkins Medical Institutions ( email )

550 N. Broadway
Baltimore, MD 21205
United States

Mary Simmerling

Adler University ( email )

17 N. Dearborn
Chicago, IL 60604
United States

Cornell University, Weill Cornell Medical College ( email )

1300 York Avenue
New York, NY 10065
United States

HOME PAGE: http://https://vivo.weill.cornell.edu/display/cwid-mcs2006

Robert Montgomery

Johns Hopkins University - Johns Hopkins Medical Institutions ( email )

550 N. Broadway
Baltimore, MD 21205
United States

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