TY - JOUR
T1 - Expanding the Living Donor Pool "Second Act": Laparoscopic Donor Nephrectomy and ABO-Incompatible Kidney Transplantation Improve Donor Recruitment
AU - Romagnoli, Jacopo
AU - Salerno, M. P.
AU - Salerno, Maria Paola
AU - Mamode, N.
AU - Calia, R.
AU - Calia, Rosaria
AU - Spagnoletti, Gionata
AU - Bianchi, V.
AU - Bianchi, Valentina
AU - Maresca, Maddalena
AU - Piccirillo, Nicola
AU - Putzulu, Rossana
AU - Piselli, P.
AU - Cola, E.
AU - Colaiori, Enzo
AU - Zini Tanzi, Gina
AU - Citterio, Franco
PY - 2015
Y1 - 2015
N2 - BACKGROUND:
To safely expand our living donor pool, we recently decided to work on 3 areas: analysis of causes of exclusion of potential donors, the results of which we recently published, introduction of laparoscopic donor nephrectomy (LDN), and ABO-incompatible (ABOi) transplantation. We sought to determine the impact of the new strategy on living donor recruitment and transplantation during over a 10-year period at a single institution.
METHODS:
From January 2005 to September 2014, we evaluated 131 living donors. Of these, 80 (61%) were genetically related, 51 (39%) unrelated, 119 (91%) ABO compatible (ABOc), 12 ABOi (9%). The analysis was divided into 2 eras: era 1, 2005-2010 (n = 53) included the use of open lumbotomy and acceptance of ABOc only; and era 2, 2011-2014 (n = 78), which saw the introduction of LDN and ABOi transplantation.
RESULTS:
Forty-five (34%) potential candidates successfully donated, 67 (51%) were excluded, and 19 (15%) were actively undergoing evaluation. Overall, 53 potential donors were evaluated in era 1 (8.8 donors/year), 78 in era 2 (19.5 donors/year). There were fewer excluded donors in era 2 vs era 1 (62% era 1 vs 44% era 2), and living donor kidney transplantation (LDKT) significantly increased in era 2 vs era 1 (3.3/year era 1 vs 7.1/year era 2). The establishment of an ABOi LDKT program led to a 15% increase of evaluations in era 2 (12/78 donors).
CONCLUSIONS:
LDN along with ABOi LDKT allowed for an improvement in recruitment of living donors and corresponding LDKT.
AB - BACKGROUND:
To safely expand our living donor pool, we recently decided to work on 3 areas: analysis of causes of exclusion of potential donors, the results of which we recently published, introduction of laparoscopic donor nephrectomy (LDN), and ABO-incompatible (ABOi) transplantation. We sought to determine the impact of the new strategy on living donor recruitment and transplantation during over a 10-year period at a single institution.
METHODS:
From January 2005 to September 2014, we evaluated 131 living donors. Of these, 80 (61%) were genetically related, 51 (39%) unrelated, 119 (91%) ABO compatible (ABOc), 12 ABOi (9%). The analysis was divided into 2 eras: era 1, 2005-2010 (n = 53) included the use of open lumbotomy and acceptance of ABOc only; and era 2, 2011-2014 (n = 78), which saw the introduction of LDN and ABOi transplantation.
RESULTS:
Forty-five (34%) potential candidates successfully donated, 67 (51%) were excluded, and 19 (15%) were actively undergoing evaluation. Overall, 53 potential donors were evaluated in era 1 (8.8 donors/year), 78 in era 2 (19.5 donors/year). There were fewer excluded donors in era 2 vs era 1 (62% era 1 vs 44% era 2), and living donor kidney transplantation (LDKT) significantly increased in era 2 vs era 1 (3.3/year era 1 vs 7.1/year era 2). The establishment of an ABOi LDKT program led to a 15% increase of evaluations in era 2 (12/78 donors).
CONCLUSIONS:
LDN along with ABOi LDKT allowed for an improvement in recruitment of living donors and corresponding LDKT.
KW - ABO INCOMPATIBLE
KW - TRANSPLANTATION
KW - ABO INCOMPATIBLE
KW - TRANSPLANTATION
UR - http://hdl.handle.net/10807/71808
U2 - 10.1016/j.transproceed.2014.11.071
DO - 10.1016/j.transproceed.2014.11.071
M3 - Article
SN - 0041-1345
VL - 47
SP - 2126
EP - 2129
JO - Transplantation Proceedings
JF - Transplantation Proceedings
ER -