Kidney exchange transplantation current status, an update and future perspectives

Table 2 Key features of success in single center kidney exchange program in India

Education, awareness, counselling of about risk and benefits of available transplant options[11-23]
Kidney exchange registry of incompatible pairs
Dedicated transplant team to overcome logistic problems
Uniform evaluation, care and follow-up
Complete work up of pairs before allocation avoids chain collapse
Standardization of HLA laboratory
Robust Immunological evaluation prevents unequal outcome in pairs
Non-anonymous allocation increases trust between pairs and transplant team
Exchange kidney of similar quality
Bonus for difficult to match and better HLA matched pairs
Use of short (≤ 4-way exchange) vs long chain minimises logistic problems
Simultaneous surgeries avoid risk of donor reneging
Improve program using key features of other successful programs
Legal, ethical, fair, transparent, equitable and patient centric policy by Competent Authorities

HLA: Human leukocyte antigen.