AUTHOR: Bruno A. Lima, Leonídio Dias, António C. Henriques, Helena Alves
KEYWORDS: Kidney paired donation, kidney transplantation, live donation, match algorithm
ABSTRACT: The growing disparity between the number of patients on the national list waiting for a kidney transplant and the number of deceased donors has compelled transplant programs to seek ways to increase the number of organs available for transplantation. Rapaport formulated the principle of paired exchange in 1986, giving it the title “kidney paired donation” (KPD). Individuals who are unable to donate a kidney to a loved one due to immunologic incompatibility are exchanged in order to form compatible pairs; the volunteers thus become living donors for unknown recipients. The aim of this study is to describe the algorithm for the Portuguese KPD program that will being in 2009.
Data were used from five patients with an incompatible blood type living donor and eight patients, each with a positive crossmatch living donor; one of the latter recipients had four positive crossmatch living donors. We present a computer match that selects exchange combinations with the following hierarchy: 1) maximum number of matched pairs; 2) blood type O recipients are given priority in receiving from blood type O donors; 3) pairs with a higher donor/recipient average match score. With a sample of thirteen incompatible donor/recipients pairs, we were able to define seven possible transplants.
The algorithm described helped to ensure an allocation program that was as equitable as possible based on medical criteria without compromising the possible number of transplants.
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