title: Successful three-way kidney paired donation with compatible pairs to increase donor pool.
abstract: Despite heightened international interest in performing living donor kidney paired donation (KPD) transplantation after the publication of a research protocol by Ross and colleagues in 1997, only a few hundred have been performed worldwide. The major obstacle is that many individuals in end-stage renal disease are of blood type O and can only receive an organ from a donor of blood type O, whereas blood type O donors are "universal donors" and will be able to donate directly with an intended recipient of any blood type unless there is a positive crossmatch. To overcome this, patients with compatible but non-HLA identical donors over 45 years of age should be approached for inclusion in KPD program especially O blood group donors. Inclusion of all these additional pairs into the algorithm greatly increases chances of possible matches for O blood group recipients. We report successful three-way KPD transplantation resulting in transplantation of O blood group patient using compatible O blood group donor from India. None of the patients had delayed graft function or rejection and all had stable graft function on discharge without any medical and surgical complications. We need to allocate O blood group kidneys from compatible donors to overcome the barrier of HLA, non-HLA antibodies and other donor related factors to improve transplant quality and long term outcomes. This will increase transplantation of O blood group patients.
authors.affiliation: Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, Gujarat , India .
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Manoj R
authors.initials: MR
authors.lastname: Gumber
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.forename: Divyesh P
authors.initials: DP
authors.lastname: Engineer
authors.forename: Manish R
authors.initials: MR
authors.lastname: Balwani
authors.forename: Rajesh Singh
authors.initials: RS
authors.lastname: Gautam
authors.forename: Dinesh N
authors.initials: DN
authors.lastname: Gera
authors.forename: Pranjal R
authors.initials: PR
authors.lastname: Modi
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000328:Adult; D046148:Donor Selection; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D006680:HLA Antigens