TY - JOUR
T1 - Temporal trends in kidney paired donation in the United States
T2 - 2006-2021 UNOS/OPTN database analysis
AU - Garg, Neetika
AU - Thiessen, Carrie
AU - Reese, Peter P.
AU - Cooper, Matthew
AU - Leishman, Ruthanne
AU - Friedewald, John
AU - Sharfuddin, Asif A.
AU - Nishio Lucar, Angie G.
AU - Dadhania, Darshana M.
AU - Kumar, Vineeta
AU - Waterman, Amy D.
AU - Mandelbrot, Didier A.
N1 - Funding Information:
D.A.M. is the recipient of an unrestricted research grant from the Virginia Lee Cook Foundation , which supported this study.
Publisher Copyright:
© 2023 American Society of Transplantation & American Society of Transplant Surgeons
PY - 2024/1
Y1 - 2024/1
N2 - Kidney paired donation (KPD) is a major innovation that is changing the landscape of kidney transplantation in the United States. We used the 2006-2021 United Network for Organ Sharing data to examine trends over time. KPD is increasing, with 1 in 5 living donor kidney transplants (LDKTs) in 2021 facilitated by KPD. The proportion of LDKT performed via KPD was comparable for non-Whites and Whites. An increasing proportion of KPD transplants are going to non-Whites. End-chain recipients are not identified in the database. To what extent these trends reflect how end-chain kidneys are allocated, as opposed to increase in living donation among minorities, remains unclear. Half the LDKT in 2021 in sensitized (panel reactive antibody ≥ 80%) and highly sensitized (panel reactive antibody ≥ 98%) groups occurred via KPD. Yet, the proportion of KPD transplants performed in sensitized recipients has declined since 2013, likely due to changes in the deceased donor allocation policies and newer KPD strategies such as compatible KPD. In 2021, 40% of the programs reported not performing any KPD transplants. Our study highlights the need for understanding barriers to pursuing and expanding KPD at the center level and the need for more detailed and accurate data collection at the national level.
AB - Kidney paired donation (KPD) is a major innovation that is changing the landscape of kidney transplantation in the United States. We used the 2006-2021 United Network for Organ Sharing data to examine trends over time. KPD is increasing, with 1 in 5 living donor kidney transplants (LDKTs) in 2021 facilitated by KPD. The proportion of LDKT performed via KPD was comparable for non-Whites and Whites. An increasing proportion of KPD transplants are going to non-Whites. End-chain recipients are not identified in the database. To what extent these trends reflect how end-chain kidneys are allocated, as opposed to increase in living donation among minorities, remains unclear. Half the LDKT in 2021 in sensitized (panel reactive antibody ≥ 80%) and highly sensitized (panel reactive antibody ≥ 98%) groups occurred via KPD. Yet, the proportion of KPD transplants performed in sensitized recipients has declined since 2013, likely due to changes in the deceased donor allocation policies and newer KPD strategies such as compatible KPD. In 2021, 40% of the programs reported not performing any KPD transplants. Our study highlights the need for understanding barriers to pursuing and expanding KPD at the center level and the need for more detailed and accurate data collection at the national level.
KW - epidemiology
KW - kidney paired donation
KW - living kidney donor transplantation
KW - race
KW - racial disparities
KW - United States
KW - Humans
KW - Tissue and Organ Harvesting
KW - Tissue and Organ Procurement
KW - Kidney Transplantation
KW - Living Donors
KW - Kidney
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U2 - 10.1016/j.ajt.2023.09.006
DO - 10.1016/j.ajt.2023.09.006
M3 - Article
C2 - 37739347
AN - SCOPUS:85173311390
SN - 1600-6135
VL - 24
SP - 46
EP - 56
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 1
ER -