Strategies to increase living kidney donation: a retrospective cohort study.
BACKGROUND
Living kidney transplantation (LKT) offers the best medical outcomes for organ recipients. Historically, our centre had a low rate of LKT. In 2009, in an effort to increase living organ donation (LOD), a dedicated team was created. Its mandate was to promote LOD at our centre and at referring centres, to coordinate assessments of living organ donors, to facilitate the process, and to ensure long-term follow-up after the donation. In November 2010, our centre joined the national living donor paired exchange registry (LDPE).


OBJECTIVE
To document the impact of the LOD team and LDPE registry on LOD rates at our centre.


METHODS
Retrospective cohort study.


METHODS
Single center study in a university hospital with an adult kidney transplant program.


METHODS
Using our electronic database, we included all potential living organ donors who contacted our centre from 01/01/2005 to 31/12/2008 and from 01/01/2009 to 31/12/2012. Follow-up was conducted until 31/12/2013.


METHODS
Number of transplantations from living donors, number of potential donors who contacted the centre, donor and recipient characteristics.


METHODS
We compared the number of transplantations from living donors performed and the number of potential donors who contacted the centre before and after the creation of the LOD team and participation in the LDPE.


RESULTS
A total of 50 renal transplantations were performed using organs from living donors during the first time period, whereas this increased to 73 in the 2009-2012 cohort (incidence rate difference (IRD): 0.030, 95% confidence interval (CI) 0.003-0.056). We also observed a significant increase in the number of individuals who contacted our centre to donate a kidney. During the 2005-2008 period (cohort 1), 191 individuals interested in donating a kidney contacted our centre, whereas this figure was 304 during the 2009-2012 period (cohort 2) (IRD: 0.143, 95% CI 0.091-0.196).


CONCLUSIONS
Single center study, relatively low sample size.


CONCLUSIONS
The implementation of a LOD team, combined with our participation in the LDPE registry, was associated with a significant increase in the actual number of living kidney transplantations performed. These data support initiatives such as the creation of dedicated LOD teams and LDPE registry to increase LKT.
Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Canada ; Nephrology and Transplantation Division, Centre hospitalier de l'Université de Montréal (CHUM), 1560 Sherbrooke Street East, H2L 4M1 Montreal, QC Canada.
Héloïse
H
Cardinal
Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.
Céline
C
Durand
Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.
Sandra
S
Larrivée
Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.
Jacobien
J
Verhave
Nephrology and Transplantation Division, Centre hospitalier de l'Université de Montréal (CHUM), 1560 Sherbrooke Street East, H2L 4M1 Montreal, QC Canada.
Michel R
MR
Pâquet
Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Canada ; Nephrology and Transplantation Division, Centre hospitalier de l'Université de Montréal (CHUM), 1560 Sherbrooke Street East, H2L 4M1 Montreal, QC Canada ; Bioethics Program, Department of Social and Preventive Medicine, École de santé publique de l'Université de Montréal, Montréal, Canada.
Marie-Chantal
MC
Fortin