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After years of growth, fewer transplants done through 'kidney chains'
Date:3/12/2013

An additional 1,000 patients could undergo kidney transplants in the United States annually if hospitals performed more transplants using paired kidney exchanges, new Johns Hopkins research suggests.

Also known as kidney chains, paired kidney exchanges, which allow incompatible donors to give a kidney on a loved one's behalf and ensure that loved one gets a compatible kidney from a third party usually a stranger in return, have become much more common since 1999 when The Johns Hopkins Hospital pioneered the practice. But the dramatic growth in the use of these exchanges from 93 transplants in 2006 to 553 in 2010 has now stalled, primarily because of financial barriers related to logistics, administrative costs and insurance coverage for donors, researchers say.

A report on the research appears online in the American Journal of Transplantation.

"There are more than 100,000 people waiting for a kidney transplant in the United States. For the one-third of patients who manage to find a living donor but learn they are the wrong blood type or are otherwise incompatible, kidney exchanges offer a very high rate of successful transplantation," says study leader Dorry L. Segev, M.D., Ph.D., an associate professor of surgery and epidemiology at the Johns Hopkins University School of Medicine. "But many transplant centers have not found a way to make this possible for their patients."

The success of kidney chains depends on the best possible matches, and these depend in turn on the largest possible pool of transplant candidates and their incompatible donors. With more centers participating, Segev says, more matches can be found and more transplants can be done.

The researchers found that between January 2009 and December 2011, while 161 transplant centers (77 percent of the 207 in the United States) performed at least one transplant through a kidney exchange, most were performing fewer than would be expected. In fact,
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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