학술논문

Temporal changes in the composition of a large multicenter kidney exchange clearinghouse: Do the hard-to-match accumulate?
Document Type
article
Source
American Journal of Transplantation. 18(11)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Kidney Disease
Transplantation
Renal and urogenital
Blood Grouping and Crossmatching
Donor Selection
Female
Follow-Up Studies
Histocompatibility Testing
Humans
Kidney Transplantation
Male
Middle Aged
Multicenter Studies as Topic
Prognosis
Registries
Tissue Donors
Tissue and Organ Procurement
donors and donation: living
donors and donation: paired exchange
health services and outcomes research
kidney transplantation/nephrology
kidney transplantation: living donor
sensitization
Medical and Health Sciences
Surgery
Clinical sciences
Immunology
Language
Abstract
One criticism of kidney paired donation (KPD) is that easy-to-match candidates leave the registry quickly, thus concentrating the pool with hard-to-match sensitized and blood type O candidates. We studied candidate/donor pairs who registered with the National Kidney Registry (NKR), the largest US KPD clearinghouse, from January 2012-June 2016. There were no changes in age, gender, BMI, race, ABO blood type, or panel-reactive antibody (PRA) of newly registering candidates over time, with consistent registration of hard-to-match candidates (59% type O and 38% PRA ≥97%). However, there was no accumulation of type O candidates over time, presumably due to increasing numbers of nondirected type O donors. Although there was an initial accumulation of candidates with PRA ≥97% (from 33% of the pool in 2012% to 43% in 2014, P = .03), the proportion decreased to 17% by June 2016 (P