title: Clinical outcomes of multicenter domino kidney paired donation.
abstract: Domino kidney paired donation (KPD) is a method by which an altruistic living nondirected donor (LND) is allocated to a pool of incompatible donor-recipient pairs (DRP) and a series of KPDs is initiated. To evaluate the feasibility and clinical outcomes of multicenter domino KPD, we retrospectively analyzed a cohort of DRPs who underwent domino KPD between February 2001 and July 2007 at one of 16 transplant centers. One hundred seventy-nine kidney transplants were performed, with 70 domino chains initiated by altruistic LND. There were 45 two-pair chains, 15 three-pair chains, 7 four-pair chains, 2 five-pair chains and 1 six-pair chain. A majority of donors were spouses (47.5%) or altruistic LNDs (39.1%). DRPs with a blood type O recipient or an AB donor comprised 45.9% of transplanted DRPs. HLA mismatch improved in transplanted donors compared to intended donors in pairs enrolled to improve HLA mismatch (3.4 +/- 0.7 vs. 4.8 +/- 1.0, p < 0.001). One-year and 5-year graft survival rates were 98.3% and 87.7%, respectively, with a median follow-up of 46 months. One-year and 5-year patient survival rates were 97.2% and 90.8%, respectively. In conclusion, multicenter domino KPD could multiply the benefits of donation from LNDs, with patients and graft survival rates comparable to those seen with conventional KPD.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
authors.forename: S U
authors.initials: SU
authors.lastname: Lee
authors.forename: S Y
authors.initials: SY
authors.lastname: Chung
authors.forename: B H
authors.initials: BH
authors.lastname: Cho
authors.forename: J Y
authors.initials: JY
authors.lastname: Kwak
authors.forename: C M
authors.initials: CM
authors.lastname: Kang
authors.forename: J T
authors.initials: JT
authors.lastname: Park
authors.forename: D J
authors.initials: DJ
authors.lastname: Han
authors.forename: D J
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000533:Altruism; D006801:Humans; D016030:Kidney Transplantation; D014019:Tissue Donors; D016896:Treatment Outcome