title: Living donor kidney paired donation  transplantation: experience as a founding  member center of the National Kidney  Registry.
abstract: Kidney paired donation (KPD) is a safe and effective means of transplantation for transplant candidates with willing but incompatible donors. We report our single-center experience with KPD through participation in the National Kidney Registry. Patient demographics, transplant rates, and clinical outcomes including delayed graft function (DGF), rejection, and survival were analyzed. We also review strategies employed by our center to maximize living donor transplantation through KPD. We entered 44 incompatible donor/recipient pairs into KPD from 9/2007 to 1/2011, enabling 50 transplants. Incompatibility was attributable to blood type (54.4%) and donor-specific sensitization (43.2%). Thirty-six candidates (81.8%) were transplanted after 157 d (median), enabling pre-emptive transplantation in eight patients. Fourteen candidates on the deceased donor waiting list also received transplants. More than 50% of kidneys were received from other transplant centers. DGF occurred in 6%; one-yr rejection rate was 9.1%. One-yr patient and graft survival was 98.0% and 94.8%. KPD involving participation of multiple transplant centers can provide opportunities for transplantation, with potential to expand the donor pool, minimize waiting times, and enable pre-emptive transplantation. Our experience demonstrates promising short-term outcomes; however, longer follow-up is needed to assess the impact of KPD on the shortage of organs available for transplantation.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Weill Cornell Medical College, New York, NY 10065, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Leeser
authors.forename: Meredith J
authors.initials: MJ
authors.lastname: Aull
authors.forename: Cheguevara
authors.initials: C
authors.lastname: Afaneh
authors.forename: Darshana
authors.initials: D
authors.lastname: Dadhania
authors.forename: Marian
authors.initials: M
authors.lastname: Charlton
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Walker
authors.forename: Choli
authors.initials: C
authors.lastname: Hartono
authors.forename: David
authors.initials: D
authors.lastname: Serur
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Del Pizzo
authors.forename: Sandip
authors.initials: S
authors.lastname: Kapur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000639:trends*; D055815:Young Adult