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Annual kidney transplants may grow as a result of deceased donor chain kidneys

Writer's picture: Jay BlumJay Blum

According to statistics published in the Kidney International Reports, simulations suggested that incorporating deceased donor kidneys in transplant chains might boost the number of transplants by 290 each year.  Furthermore, the use of deceased donors can enhance the number of transplants for blood type O kidney-paired donation candidates, according to the researchers.


"Rather than directly donating to a candidate on the waitlist, deceased donor kidneys (DD) could achieve additional transplants by donating to a candidate in a kidney-paired donation (KPD) pool, thereby initiating a chain that ends with a living donor (LD) donating to a candidate on the waitlist," wrote Wen Wang, PhD, a research fellow at the University of Michigan's department of biostatistics, and colleagues. "Following previous research in this field, three natural questions arise: 1) can longer DD initiated chains produce more transplants; 2) can longer DD initiated chains reduce the number of deceased donor chain initiating kidneys (DD-CIKs); and 3) can longer DD initiated chains balance the number of blood type O DD-CIKs and LDs returning to the waitlist."


Based on DD and waitlist data from the United States in 2016 and 2017, Wang and colleagues developed techniques to allow DD to launch KPD chains. The KDP pools, on the other hand, were created using LDs and a large percentage of highly sensitive and/or blood type O applicants.


Researchers used the simulations to assess six options that were intended with "easy of implementation in mind, and in each scenario, fewer than 3% of the total national number of DD kidneys are allocated to the KPD pool."


When compared to shorter DD-initiated KPD chains, longer DD-initiated KPD chains increased the number of KPD transplants by up to 5% and reduced the number of DDs granted to the KPD pool by 25%. According to the research, investing less than 3% of DD to launch KPD chains could result in an additional 290 kidney transplants per year.


Wang and colleagues wrote, "In conclusion, this study simulates the use of DD-CIKs and suggests several new strategies that can further increase the total number of kidney transplants, the number of blood type O transplants, the number of transplants from within the KPD pool, and the number of transplants for candidates on the DD waitlist." "These procedures would also make LD kidneys available to candidates who are on the waiting list for DD transplantation but do not have access to them otherwise."


Researchers stated that they are working on a more thorough model to evaluate the impact of policy changes on waitlist applicants with blood type O, members of underrepresented groups, or members of various candidate groupings.

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