The first 9 years of kidney paired donation through the National Kidney Registry: Characteristics of donors and recipients compared with National Live Donor Transplant Registries

Stuart M. Flechner*, Alvin G. Thomas, Matthew Ronin, Jeffrey L. Veale, David B. Leeser, Sandip Kapur, John Devin Peipert, Dorry L. Segev, Macey L. Henderson, Ashton A. Shaffer, Matthew Cooper, Garet Hil, Amy D. Waterman

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.

Original languageEnglish (US)
Pages (from-to)2730-2738
Number of pages9
JournalAmerican Journal of Transplantation
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2018

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Tissue Donors
Kidney
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Insurance
Demography

Keywords

  • clinical research/practice
  • donors and donation: living
  • donors and donation: paired exchange
  • kidney transplantation/nephrology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Flechner, Stuart M. ; Thomas, Alvin G. ; Ronin, Matthew ; Veale, Jeffrey L. ; Leeser, David B. ; Kapur, Sandip ; Peipert, John Devin ; Segev, Dorry L. ; Henderson, Macey L. ; Shaffer, Ashton A. ; Cooper, Matthew ; Hil, Garet ; Waterman, Amy D. / The first 9 years of kidney paired donation through the National Kidney Registry : Characteristics of donors and recipients compared with National Live Donor Transplant Registries. In: American Journal of Transplantation. 2018 ; Vol. 18, No. 11. pp. 2730-2738.
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abstract = "The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6{\%} vs 11.5{\%}), hyperimmunized recipients (22.7{\%} vs 4.3{\%} were cPRA >80{\%}), female recipients (45.9{\%} vs 37.6{\%}), black recipients (18.2{\%} vs 13{\%}), and those on public insurance (49.7{\%} vs 41.8{\%}) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.",
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author = "Flechner, {Stuart M.} and Thomas, {Alvin G.} and Matthew Ronin and Veale, {Jeffrey L.} and Leeser, {David B.} and Sandip Kapur and Peipert, {John Devin} and Segev, {Dorry L.} and Henderson, {Macey L.} and Shaffer, {Ashton A.} and Matthew Cooper and Garet Hil and Waterman, {Amy D.}",
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Flechner, SM, Thomas, AG, Ronin, M, Veale, JL, Leeser, DB, Kapur, S, Peipert, JD, Segev, DL, Henderson, ML, Shaffer, AA, Cooper, M, Hil, G & Waterman, AD 2018, 'The first 9 years of kidney paired donation through the National Kidney Registry: Characteristics of donors and recipients compared with National Live Donor Transplant Registries', American Journal of Transplantation, vol. 18, no. 11, pp. 2730-2738. https://doi.org/10.1111/ajt.14744

The first 9 years of kidney paired donation through the National Kidney Registry : Characteristics of donors and recipients compared with National Live Donor Transplant Registries. / Flechner, Stuart M.; Thomas, Alvin G.; Ronin, Matthew; Veale, Jeffrey L.; Leeser, David B.; Kapur, Sandip; Peipert, John Devin; Segev, Dorry L.; Henderson, Macey L.; Shaffer, Ashton A.; Cooper, Matthew; Hil, Garet; Waterman, Amy D.

In: American Journal of Transplantation, Vol. 18, No. 11, 01.11.2018, p. 2730-2738.

Research output: Contribution to journalArticle

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T1 - The first 9 years of kidney paired donation through the National Kidney Registry

T2 - Characteristics of donors and recipients compared with National Live Donor Transplant Registries

AU - Flechner, Stuart M.

AU - Thomas, Alvin G.

AU - Ronin, Matthew

AU - Veale, Jeffrey L.

AU - Leeser, David B.

AU - Kapur, Sandip

AU - Peipert, John Devin

AU - Segev, Dorry L.

AU - Henderson, Macey L.

AU - Shaffer, Ashton A.

AU - Cooper, Matthew

AU - Hil, Garet

AU - Waterman, Amy D.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.

AB - The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplant to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared with national registries. For this purpose, we merged data from the NKR database with the Scientific Registry of Transplant Recipients (SRTR) database, from February 14, 2008, to February 14, 2017, encompassing the first 9 years of the NKR. Compared with all United Network for Organ Sharing (UNOS) live donor transplant patients (49 610), all UNOS living unrelated transplant patients (23 319), and all other KPD transplant patients (4236), the demographic and clinical characteristics of NKR transplant patients (2037) appear similar to contemporary national trends. In particular, among the NKR patients, there were a significantly (P <.001) greater number of retransplants (25.6% vs 11.5%), hyperimmunized recipients (22.7% vs 4.3% were cPRA >80%), female recipients (45.9% vs 37.6%), black recipients (18.2% vs 13%), and those on public insurance (49.7% vs 41.8%) compared with controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by the entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder-to-match pairs.

KW - clinical research/practice

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KW - donors and donation: paired exchange

KW - kidney transplantation/nephrology

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