PMID- 21839256
OWN - NLM
STAT- MEDLINE
DCOM- 20120105
LR  - 20110815
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 43
IP  - 6
DP  - 2011 Jul-Aug
TI  - Effectiveness of different kidney exchange mechanisms to improve living donor 
      transplantation in Chile.
PG  - 2283-7
LID - 10.1016/j.transproceed.2011.06.001 [doi]
AB  - INTRODUCTION: Chile has a low cadaveric organ donation rate; at the same time, 
      living donor transplantation activity is also low. The purpose of this study was 
      to analyze the impact on the number and quality of transplants using various 
      mechanisms for kidney exchange from living donors to patients on Chile's waiting 
      list. METHODS: A computerized model was developed to simulate five options for 
      living kidney donation: (1) direct donation; (2) direct donation plus pairwise 
      and three-way exchanges; (3) pairwise exchange; (4) three-way exchange; and (5) 
      allocation of donors based on the top trading cycles (TTC) mechanism. We 
      calculated the projected number of transplantations, adjusting for the risk of a 
      positive crossmatch, as well as the average quality in terms of the human 
      leukocyte antigen (HLA) match. RESULTS: If all patients on the waiting list have 
      a willing direct donor, 47.7% of patients will receive a transplant. Allowing for 
      incompatible pairs or pairs with a positive crossmatch an exchange of kidneys, 
      can increase the number to 51.8%. This figure rises to 60% or 61% for pairwise or 
      three-way exchanges, respectively. Although TTC ensures that 55% of the patients 
      could be transplanted, the graft quality is better with an average HLA match of 
      3.5 versus 1.25. CONCLUSIONS: These results showed that kidney exchange 
      mechanisms can increase the number of living donor transplantations by 4% and 
      13%.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Dominguez, J
AU  - Dominguez J
AD  - Facultad de Medicina, Departamento de Urologia, Pontificia Universidad Catolica 
      de Chile, Santiago, Chile. javierdomi@hotmail.com
FAU - Harrison, R
AU  - Harrison R
FAU - Contreras, D
AU  - Contreras D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Algorithms
MH  - Chile
MH  - Computer Simulation
MH  - HLA Antigens/immunology
MH  - Histocompatibility
MH  - Humans
MH  - *Kidney Transplantation/immunology
MH  - Living Donors/*supply & distribution
MH  - Middle Aged
MH  - Program Development
MH  - Time Factors
MH  - Tissue and Organ Procurement/*methods
MH  - Treatment Outcome
MH  - Waiting Lists
EDAT- 2011/08/16 06:00
MHDA- 2012/01/06 06:00
CRDT- 2011/08/16 06:00
PHST- 2011/08/16 06:00 [entrez]
PHST- 2011/08/16 06:00 [pubmed]
PHST- 2012/01/06 06:00 [medline]
AID - S0041-1345(11)00809-8 [pii]
AID - 10.1016/j.transproceed.2011.06.001 [doi]
PST - ppublish
SO  - Transplant Proc. 2011 Jul-Aug;43(6):2283-7. doi: 
      10.1016/j.transproceed.2011.06.001.