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  • Title: Paired exchange programmes can expand the live kidney donor pool.
    Author: Mahendran AO, Veitch PS.
    Journal: Br J Surg; 2007 Jun; 94(6):657-64. PubMed ID: 17514699.
    Abstract:
    BACKGROUND: Kidney paired donation (KPD) is an exchange of organs between two live donors, who are otherwise ABO incompatible or cross-match positive, and their intended recipients. The outcome is the generation of compatible transplants conferring an improvement in quality of life and longevity. METHODS: Medline was searched for articles on KPD using a combination of keywords. Publications focusing on protocols and policy, mathematical modelling, ethical controversies, and legal and logistical barriers were identified. RESULTS: Many are precluded from transplantation because of incompatibilities with their intended donors. KPD has the potential to increase the rate of transplantation by facilitating exchange transplants between otherwise incompatible donor-recipient couples. Ethical controversies surrounding paired donation include confidentiality, conditionality of donation, synchronicity of operations and the possibility of disadvantaging blood group O recipients. Logistical barriers hampering KPD programmes involve the location of donor surgery and organ transport. CONCLUSION: Paired donation may expand the living donor pool by providing an alternative successful strategy for incompatible donor-recipient couples. Its widespread implementation will depend on resolving ethical and logistical constraints.
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