Outcome of multipair donor kidney exchange by a web-based algorithm.
Donor kidney exchange is an established method to overcome incompatibility of donor-recipient pairs (DRP). A computerized algorithm was devised to exchange donor kidney and was tested in a multicenter setting. The algorithm was made according to the consensus of participating centers. It makes all possible exchange combinations not only between two incompatible DRP but also circularly among three DRP and selects an optimum set of exchange combinations, considering several factors that can affect the outcome of the exchanged transplant. The algorithm was implemented as a web-based program, and matching was performed five times. Fifty-three DRP were enrolled from five transplant centers. The numbers of DRP that were enrolled in each matching were 38 (25:13), 39 (34:5), 33 (31:2), 32 (28:4), and 34 (30:4) (carryover:newcomer). The numbers of generated exchange combinations were 4:11, 3:17, 2:12, 2:3, and 2:3 (two-pair exchange:three-pair exchange), and the numbers of DRP in selected exchange combinations were six, 12, six, five, and four in each matching. The numbers of DRP with blood type O recipient or AB donor were five and one, respectively, in selected exchange combinations. Six DRP of two-pair exchange combinations and six DRP of three-pair exchange combinations underwent transplantation successfully. Computerized algorithm of donor kidney exchange was tried not only between two incompatible DRP but also circularly among three DRP. It showed that the algorithm has potential to improve the outcome of donor kidney exchange, especially for disadvantaged DRP with blood type O recipients or AB donors.
Kim
Beom Seok
BS
Department of Internal Medicine, Institute of Kidney Desease, Yonsei University College of Medicine, Korea.
Kim
Yu Seun
YS
Kim
Soon Il
SI
Kim
Myoung Soo
MS
Lee
Ho Yung
HY
Kim
Yong-Lim
YL
Kim
Chan Duck
CD
Yang
Chul Woo
CW
Choi
Bum Soon
BS
Han
Duck Jong
DJ
Kim
Yon Su
YS
Kim
Sung Joo
SJ
Oh
Ha-Young
HY
Kim
Dae Joong
DJ
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D000465:Algorithms; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D003201:Computers; D046148:Donor Selection / Q000379:methods; D005260:Female; D006801:Humans; D020407:Internet; D016030:Kidney Transplantation / Q000276:immunology*; D007723:Korea; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000458:organization & administration
D000017:ABO Blood-Group System