Kidney paired donation: a plea for a Swiss National Programme.
Growing incidence of end-stage renal disease, shortage of kidneys from deceased donors and a better outcome for recipients of kidneys from living donor have led many centres worldwide to favour living donor kidney transplantation programmes. Although criteria for living donation have greatly evolved in recent years with acceptance of related and unrelated donors, an immunological incompatibility, either due to ABO incompatibility and/or to positive cross-match, between a living donor and the intended recipient, could impede up to 40% of such procedures. To avoid refusal of willing and healthy living donors, a number of strategies have emerged to overcome immunological incompatibilities. Kidney paired donation is the safest way for such patients to undergo kidney transplantation. Implemented with success in many countries either as national or multiple regional independent programmes, it could include simple exchanges between any number of incompatible pairs, incorporate compatible pairs and non-directed donors (NDDs) to start a chain of compatible transplantations, lead to acceptance of ABO-incompatible matching, and integrate desensitising protocols. Incorporating all variations of kidney paired donation, the Australian programme has been able to facilitate kidney transplantation in 49% of registered incompatible pairs. This review is a plea for implementing a national kidney paired donation programme in Switzerland.
Service of Nephrology. Geneva University Hospital, Geneva, Switzerland; Service of Transplantation, Geneva University Hospital, Geneva, Switzerland.
Karine
K
Hadaya
Service of Nephrology and Histocompatibility laboratory, Zurich University Hospital, Switzerland.
Thomas
T
Fehr
Service of Nephrology and Histocompatibility laboratory, Zurich University Hospital, Switzerland.
Barbara
B
Rüsi
Transplant Immunology Unit and National Reference Laboratory for Histocompatibility (LNRH), Division of Immunology, Allergy and Laboratory Medicine, Geneva, Switzerland.
Sylvie
S
Ferrari-Lacraz
Transplant Immunology Unit and National Reference Laboratory for Histocompatibility (LNRH), Division of Immunology, Allergy and Laboratory Medicine, Geneva, Switzerland.
Villard
V
Jean
Department of Nephrology, Prince of Wales Hospital and Clincal School, University of New South Wales, Randwick, Sydney, Australia; Organ and Tissue Authority, Australia.
Paolo
P
Ferrari
D000465:Algorithms; D001315:Australia; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000600:supply & distribution*; D012042:Registries; D013557:Switzerland; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence / Q000379:methods*; D061349:Unrelated Donors