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World J Transplant. Apr 24, 2017; 7(2): 134-143
Published online Apr 24, 2017. doi: 10.5500/wjt.v7.i2.134
Past, present and future of kidney paired donation transplantation in India
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Manisha P Modi, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Minaxi H Patel, Varsha B Trivedi, Hargovind L Trivedi
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad 380016, India
Pranjal R Modi, Sayyed J Rizvi, Bipin C Pal, Department of Urology and transplantation, IKDRC-ITS, Ahmedabad 380016, India
Veena R Shah, Manisha P Modi, Department of Anaesthesia, IKDRC-ITS, Ahmedabad 380016, India
Minaxi H Patel, Varsha B Trivedi, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, IKDRC-ITS, Ahmedabad 380016, India
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Vivek B Kute, MBBS, MD, FCPS, DM Nephrology (Gold Medalist), FASN, Associate Professor, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr HL Trivedi Institute of Transplantation Sciences, B-130, Triveni, Ph-1, Ahmedabad 380016, India. drvivekkute@rediffmail.com
Telephone: +91-90-99927543
Received: November 1, 2016
Peer-review started: November 4, 2016
First decision: November 30, 2016
Revised: December 11, 2016
Accepted: January 2, 2017
Article in press: January 4, 2017
Published online: April 24, 2017
Processing time: 170 Days and 2.6 Hours
Abstract

One third of healthy willing living kidney donors are rejected due to ABO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where ABO incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, ABO blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or ABO incompatible transplantation, international kidney paired donation, non-simultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor pool. In absence of national kidney paired donation program, a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. This review assists in the development of similar programs in other developing countries.

Keywords: Living donor kidney transplantation; Kidney paired donation; Renal replacement therapy; Developing country

Core tip: Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or ABO incompatible transplantation, international kidney paired donation, non-simultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor pool. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients.