The British journal of surgery · 2007
Paired exchange programmes can expand the live kidney donor pool.
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Mahendran A O, Veitch P S
Аннотация
BACKGROUND: Kidney paired donation (KPD) is an exchange of organs between two live donors, who are otherwise ABO incompatible or cross-match positive, and their intended recipients. The outcome is the generation of compatible transplants conferring an improvement in quality of life and longevity.
METHODS: Medline was searched for articles on KPD using a combination of keywords. Publications focusing on protocols and policy, mathematical modelling, ethical controversies, and legal and logistical barriers were identified.
RESULTS: Many are precluded from transplantation because of incompatibilities with their intended donors. KPD has the potential to increase the rate of transplantation by facilitating exchange transplants between otherwise incompatible donor-recipient couples. Ethical controversies surrounding paired donation include confidentiality, conditionality of donation, synchronicity of operations and the possibility of disadvantaging blood group O recipients. Logistical barriers hampering KPD programmes involve the location of donor surgery and organ transport.
CONCLUSION: Paired donation may expand the living donor pool by providing an alternative successful strategy for incompatible donor-recipient couples. Its widespread implementation will depend on resolving ethical and logistical constraints.
METHODS: Medline was searched for articles on KPD using a combination of keywords. Publications focusing on protocols and policy, mathematical modelling, ethical controversies, and legal and logistical barriers were identified.
RESULTS: Many are precluded from transplantation because of incompatibilities with their intended donors. KPD has the potential to increase the rate of transplantation by facilitating exchange transplants between otherwise incompatible donor-recipient couples. Ethical controversies surrounding paired donation include confidentiality, conditionality of donation, synchronicity of operations and the possibility of disadvantaging blood group O recipients. Logistical barriers hampering KPD programmes involve the location of donor surgery and organ transport.
CONCLUSION: Paired donation may expand the living donor pool by providing an alternative successful strategy for incompatible donor-recipient couples. Its widespread implementation will depend on resolving ethical and logistical constraints.