National paired kidney exchange program confers positive outcomes
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According to a study, transplant recipients who received kidneys from a national paired kidney exchange program experienced similar post-transplant outcomes as those who received kidneys from other living donors. These results led David B. Leeser, MD, of the Brody School of Medicine at East Carolina University, to contend that “national paired kidney donor transplantation is an excellent way for patients to have a successful living donor kidney transplant.”
According to Leeser, the National Kidney Registry — a nonprofit organization comprised of 85 transplant centers within the United States — has been facilitating paired kidney exchange since 2008. Paired kidney exchange allows for recipients to receive a compatible transplant by “swapping” living donor kidneys between recipients in the network. Leeser told Healio Nephrology that his team of researchers wanted to compare outcomes between National Kidney Registry recipients and recipients of other forms of living donor transplant. The investigators included 2,363 National Kidney Registry recipients and 54,497 recipients who underwent living donor kidney transplant between February 2008 and December 2017.
After following National Kidney Registry recipients for a median of 3.7 years and controls for a median of 5.3 years, researchers found both groups experienced similar incidences of graft failure (5% vs. 6%, respectively) and mortality (9% vs. 10%, respectively).
Adjustments for donor, recipient and transplant factors conferred similar results, with no differences in graft failure and mortality between the groups.
Leeser said continued focus needs to be placed on outcomes in the longer term, as it remains unclear if the trend will persist. He also noted researchers need to develop data and tools to better understand why National Kidney Registry recipients experienced comparable outcomes, “despite having characteristics that would indicate they should do worse” (eg, patients were more likely to be African American, older, on public insurance and to have had longer duration on dialysis).
Despite these areas requiring further research, Leeser said this study suggests “large paired kidney donation programs may be superior to other forms of living donor transplant due to the ability to match recipients in a large donor pool.” – by Melissa J. Webb
Disclosure: Leeser reports associations with the data safety monitoring board at Laminate Technologies.
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