title: Outcome of multipair donor kidney exchange by a web-based algorithm.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Institute of Kidney Desease, Yonsei University College of Medicine, Korea.
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Kim
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Ho Yung
authors.initials: HY
authors.lastname: Lee
authors.forename: Yong-Lim
authors.initials: YL
authors.lastname: Kim
authors.forename: Chan Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Ha-Young
authors.initials: HY
authors.lastname: Oh
authors.forename: Dae Joong
authors.initials: DJ
authors.lastname: Kim
mesh_terms: 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
chemical_list: D000017:ABO Blood-Group System