Kidney Exchange Programme in Poland

Abstract

Background As compared with the results of kidney transplantation (KTx) procured from deceased donors (DD), kidneys procured from living organ donor (LD) provide better graft outcome. Due to the shortage of DD, living kidney donation (LKD) has become the most crucial organ pool. In Poland, the percentage of LKD is still very low and amounts 5%. Unfortunately, not all of the potential LDs that report to the transplant centre are compatible with their recipient. In such a situation, the solution for that problem might be the kidney paired donation (KPD). The first paired donation in Poland was performed in February 2015 and the first chain KPD that consisted of 3 pairs was performed 3 months later. Methods Successful transplantations in KPD resulted in that the more incompatible pairs have reported to our centre. Moreover, other transplant centers have expressed their interest to join our program. Thanks to the matching program that was created in our centre we were able to match 2 pairs from two different centers. Results Pairs of incompatible donor and recipient were not split between the centres. Kidneys were shipped via scheduled plane. One center performed retroperitoneal hand-assisted nephrectomy and the other one open minimal invasive retroperitoneal nephrectomy. In both centers the left kidney was procured. The results were as followed (open vs. lap): mean CIT was 5 h 36 min (5 h 42 min vs. 5h 31 min), mean WIT1: 3 min 40 s (2 min 20 s vs. 5 min) and mean WIT2: 28 min (30 min vs. 26 min). Good results of kidney transplantation were achieved. An immediate graft function was observed in both recipients. Recipient of laparoscopic procured kidney had mean serum creatinine level at day 3: 1.68 mg/dl, 1.27 mg/dl at discharge and 1.16 mg/dl after one month. Donors were discharged in the 4th day after the donation with mean serum creatinine level equalled 1.32 mg/dl. Conclusion The first successful multicenter kidney exchange has opened a new solution for further development of transplant medicine in Poland. Good results were achieved.