title: Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India.
abstract: OBJECTIVE
  To avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression.
  
  
  METHODS
  We present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility (n= 1); positive cross-match and/or presence of donor specific antibody (n= 5). The average time required from registration in kidney paired donation (KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo.
  
  
  RESULTS
  Graft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection (Banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo follow-up. The waiting time in KPD was short as compared to deceased donor KT.
  
  
  CONCLUSIONS
  We report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Umesh T
authors.initials: UT
authors.lastname: Varyani
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Pranjal R
authors.initials: PR
authors.lastname: Modi
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Sayyed J
authors.initials: SJ
authors.lastname: Rizvi
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Bipin C
authors.initials: BC
authors.lastname: Pal
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Priya S
authors.initials: PS
authors.lastname: Shah
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Pavan S
authors.initials: PS
authors.lastname: Wakhare
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Vijay A
authors.initials: VA
authors.lastname: Ghodela
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Saiprasad G
authors.initials: SG
authors.lastname: Shinde
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Varsha B
authors.initials: VB
authors.lastname: Trivedi
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Minaxi H
authors.initials: MH
authors.lastname: Patel
authors.affiliation: Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Hargovind L Trivedi, Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, India.
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
keywords: Donor selection/methods; Kidney paired donation; Kidney transplantation/methods; Living donors/supply and distribution