MP30-10 GLOBAL KIDNEY EXCHANGE: STRIVING FOR TRIFECTA OUTCOMES IN MANAGEMENT OF KIDNEY FAILURE

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II1 Apr 2017MP30-10 GLOBAL KIDNEY EXCHANGE: STRIVING FOR TRIFECTA OUTCOMES IN MANAGEMENT OF KIDNEY FAILURE Obi Ekwenna, Ty Dunn, Susan Rees, Jeffrey Rogers, Christian Kuhr, Alvin Roth, Laurie Reece, Kimberly Krawiec, Samay Jain, David Fumo, Christian Marsh, Alejandro Cicero, Jonathan Kopke, Miguel Tan, Puneet Sindhwani, Siegfredo Paloyo, and Michael Rees Obi EkwennaObi Ekwenna More articles by this author , Ty DunnTy Dunn More articles by this author , Susan ReesSusan Rees More articles by this author , Jeffrey RogersJeffrey Rogers More articles by this author , Christian KuhrChristian Kuhr More articles by this author , Alvin RothAlvin Roth More articles by this author , Laurie ReeceLaurie Reece More articles by this author , Kimberly KrawiecKimberly Krawiec More articles by this author , Samay JainSamay Jain More articles by this author , David FumoDavid Fumo More articles by this author , Christian MarshChristian Marsh More articles by this author , Alejandro CiceroAlejandro Cicero More articles by this author , Jonathan KopkeJonathan Kopke More articles by this author , Miguel TanMiguel Tan More articles by this author , Puneet SindhwaniPuneet Sindhwani More articles by this author , Siegfredo PaloyoSiegfredo Paloyo More articles by this author , and Michael ReesMichael Rees More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.943AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While organ shortage is the major limitation to kidney transplantation in the developed world, in resource poor countries, financial barriers prevent kidney transplantation much more often—even when willing living kidney donors are available. Global Kidney Exchange (GKE) is a unique approach that allows mutual benefit between patients-donor pairs in rich and poor nations who face barriers to transplantation. METHODS We propose that the cost difference between dialysis and transplantation in some countries would allow the exchange of kidneys between developed world patient/donor pairs with immunological barriers and developing-world patient/donor pairs with financial barriers to transplantation. RESULTS Through the GKE 3 BT-O donors (2 from the Philippines and 1 from Mexico) were identified. Three Non-simultaneous extended altruistic donors (NEAD) chain were identified with each US BT-A non-directed donor (NDD) with no match in a regional kidney paired donation (KPD) pool. A US NDD or bridge donor donated to a foreign recipient creating a chain of kidney transplants. So far a total of 27 kidney transplants have been generated, with each chain producing 12, 9 and 6 transplants respectively. The blood type of the 27 GKE recipients were BT-0 in 14, BT-A in 9, and BT-B in 4. Of the 27 GKE recipients, 10 had a PRA of 0-20%, 11 had a PRA of 21-79%, and 6 had a PRA of >80%. Two of the chains remain open at this time with bridge donors awaiting donation, with the potential to extend the number of total transplants. The transplant cost for each foreign recipient was paid for by Philanthropy. An additional, $50,000 was reserved for subsequent immunosuppression for follow-up of the foreign donor/recipient pair. The cost saving from transplanting 24 U.S patients compared with the cost of dialysis will exceed $7.3 million over a 5 year period. At most recent follow-up all patients have excellent renal function. CONCLUSIONS GKE is an innovative approach that achieves the trifecta (cost reduction, quality of life improvement, and assess to kidney transplant) in the management of all patients with End-stage renal disease by providing increased opportunities for transplantation for all blood types and levels of sensitization © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e393 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Obi Ekwenna More articles by this author Ty Dunn More articles by this author Susan Rees More articles by this author Jeffrey Rogers More articles by this author Christian Kuhr More articles by this author Alvin Roth More articles by this author Laurie Reece More articles by this author Kimberly Krawiec More articles by this author Samay Jain More articles by this author David Fumo More articles by this author Christian Marsh More articles by this author Alejandro Cicero More articles by this author Jonathan Kopke More articles by this author Miguel Tan More articles by this author Puneet Sindhwani More articles by this author Siegfredo Paloyo More articles by this author Michael Rees More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...