RT Book, Section
A1 Serur, David
A2 Molmenti, Ernesto Pompeo
SR Print(0)
ID 1194180086
T1 Kidney-Paired Donation
T2 Molmenti’s Kidney and Pancreas Transplantation: Operative Techniques and Medical Management, 2e
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781260474275
LK accesssurgery.mhmedical.com/content.aspx?aid=1194180086
RD 2024/04/25
AB Patients  with  an  ABO-incompatible  potential  living  donor  or  a  crossmatch-positive  living  donor  have  traditionally  been  relegated  to  waiting  on  the  deceased  donor  list.While  desensitization  is  available  for  some  ABO-incompatible  patients  and  some  crossmatch-positive  patients,  it  comes  at  the  price  of  an  increase  in  immunosuppression  and  the  risks  of  infection  and  malignancies.Kidney-paired  donation  (KPD)  obviates  the  need  for  this  excess  immunosuppression  by  providing  the  recipient  with  an  ABO-compatible  donor  or  a  donor  to  which  they  are  not  crossmatch  positive.Even  with  a  KPD,  it  is  at  times  difficult  to  find  matches  for  the  extremely  highly  sensitized  patients,  those  with  98–100%  calculated  Panel  Reactive  Antibodies  (cPRA).  These  patients  may  benefit  from  the  combined  approach  of  desensitization  and  KPD.Currently  KPD  transplants  account  for  1000  transplants  per  year,  about  15%  of  all  living  transplants  in  the  United  States.  It  is  not  uncommon  now  even  for  compatible  pairs  to  enter  KPD  if  the  recipient  wishes  to  obtain  a  younger  or  better-matched  kidney.It  is  estimated  that  with  a  fully  functional  national  KPD  program,  3000  extra  transplants  would  be  facilitated  per  year.