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Increasing Kidney-Exchange Options Within the Existing Living Donor Pool With CIAT: A Pilot Implementation Study.
de Klerk, Marry; Kal-van Gestel, Judith A; Roelen, Dave; Betjes, Michiel G H; de Weerd, Annelies E; Reinders, Marlies E J; van de Wetering, Jacqueline; Kho, Marcia M L; Glorie, Kristiaan; Roodnat, Joke I.
Afiliação
  • de Klerk M; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • Kal-van Gestel JA; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • Roelen D; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, Netherlands.
  • Betjes MGH; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • de Weerd AE; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • Reinders MEJ; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • van de Wetering J; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • Kho MML; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
  • Glorie K; Erasmus Q-Intelligence, Erasmus University Rotterdam, Rotterdam, Netherlands.
  • Roodnat JI; Erasmus Medical Center, Department of Internal Medicine, Transplantation Institute, Rotterdam, Netherlands.
Transpl Int ; 36: 11112, 2023.
Article em En | MEDLINE | ID: mdl-37342179
Computerized integration of alternative transplantation programs (CIAT) is a kidney-exchange program that allows AB0- and/or HLA-incompatible allocation to difficult-to-match patients, thereby increasing their chances. Altruistic donors make this available for waiting list patients as well. Strict criteria were defined for selected highly-immunized (sHI) and long waiting (LW) candidates. For LW patients AB0i allocation was allowed. sHI patients were given priority and AB0i and/or CDC cross-match negative HLAi allocations were allowed. A local pilot was established between 2017 and 2022. CIAT results were assessed against all other transplant programs available. In the period studied there were 131 incompatible couples; CIAT transplanted the highest number of couples (35%), compared to the other programs. There were 55 sHI patients; CIAT transplanted as many sHI patients as the Acceptable Mismatch program (18%); Other programs contributed less. There were 69 LW patients; 53% received deceased donor transplantations, 20% were transplanted via CIAT. In total, 72 CIAT transplants were performed: 66 compatible, 5 AB0i and 1 both AB0i and HLAi. CIAT increased opportunities for difficult-to-match patients, not by increasing pool size, but through prioritization and allowing AB0i and "low risk" HLAi allocation. CIAT is a powerful addition to the limited number of programs available for difficult-to-match patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obtenção de Tecidos e Órgãos / Transplante de Rim Limite: Humans Idioma: En Revista: Transpl Int Assunto da revista: TRANSPLANTE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obtenção de Tecidos e Órgãos / Transplante de Rim Limite: Humans Idioma: En Revista: Transpl Int Assunto da revista: TRANSPLANTE Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Holanda