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Novel Approaches to Expanding Benefits from Living Kidney Donor Chains

  • Live Kidney Donation (K Lentine, Section Editor)
  • Published:
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Abstract

Purpose of Review

Although allocation strategies such as kidney paired donation (KPD) have helped to enhance transplant opportunities for immunologically incompatible recipient and donor pairs, further expansion and optimization of KPD is possible. This review examines Global Kidney Exchange and Deceased Donors as Chain-Initiating Kidneys, two novel strategies aimed to expand the benefits of KPD.

Recent Findings

Global Kidney Exchange offers the opportunity to utilize the mechanism of kidney exchange to overcome financial barriers to kidney transplantation, thus increasing the pool of participating pairs, unlocking more chains, avoiding costs from dialysis, and expanding kidney transplantation to serve impoverished patients. The Deceased Donors as Chain-Initiating Kidneys strategy aims to increase matching opportunities by using deceased donor kidneys to initiate KPD chains.

Summary

We find that both ideas offer the promise of more kidney transplants and a reduction in the personal and economic burden caused by ESRD.

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Acknowledgments

Michael Rees was supported in part by Agency for Healthcare Research and Quality grant R18-HS-020610. The authors thank the nondirected kidney donors who made the first three GKE transplants possible. We thank all the transplant coordinators, social workers, independent donor advocates, and others whose tireless efforts make kidney exchange possible. We thank Richard Paat and Andrew Torres, who, on behalf of the Filipino Association of Toledo, provided housing, food, transportation, and entertainment for two Philippine couples during their stay in Toledo, OH. We thank Katie Burton and Chuck Lehnert, who provided housing, food, transportation, and entertainment for a Mexican donor and recipient during their stay in Toledo, OH. We thank Steven Selman on behalf of the Urology Department of the University of Toledo, the board members of the Alliance for Paired Donation, the University of Toledo, the University of Minnesota, the Virginia Mason Medical Center, Hylant, and Rejuvenate Healthcare for underwriting the financial risk had there been a donor complication in the donor giving to the GKE recipient. We thank David Morlock, Daniel Barbee, and Ronald Goedde, and Gary Lawera of the University of Toledo, who negotiated a fair price for the first three GKE transplants and bore the financial risk of a significant complication involving the Filipino and Mexican recipients. Finally, we thank Steve and Ann Stranahan, Pat and Robin Stranahan, Dave and Hillary White Jr., Dave White Sr., and four anonymous donors for financially supporting the first three GKE transplants.

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Authors and Affiliations

  1. Departments of Urology and Pathology, The University of Toledo Health Science Campus, 3000 Arlington Avenue, Toledo, OH, 43614-2598, USA

    Robert Brunner, David Fumo & Michael Rees

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  1. Robert Brunner
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  2. David Fumo
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  3. Michael Rees
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Correspondence to Michael Rees.

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Conflict of Interest

David Fumo and Robert Brunner declare no conflict of interest.

Michael Rees has an ownership interest in Rejuvenate Healthcare, LLC that may gain or lose financially as a result of this publication. Dr. Rees is the noncompensated CEO of the Alliance for Paired Donation. The other authors have no conflicts of interest to disclose. Dr. Rees reports grants from Agency for Healthcare Research and Quality (R18-HS-020610) and grants from the Alliance for Paired Donation during the conduct of the study. In addition, Dr. Rees has a patent (Transplantation Methods) pending.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Live Kidney Donation

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Brunner, R., Fumo, D. & Rees, M. Novel Approaches to Expanding Benefits from Living Kidney Donor Chains. Curr Transpl Rep 4, 67–74 (2017). https://doi.org/10.1007/s40472-017-0141-1

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