Novel strategy in living donor kidney transplantation to outcome biological barriers

Abstract

Living donor kidney transplantation (LKD) is considered the best type of transplant for end-stage renal disease patients in terms of organ quality and survival. However, ABO incompatibility and positive cross-match remain the most frequent immunological barriers. The novel strategy of kidney paired donation (KPD) has been proposed to facilitate transplantation in patients who have a healthy and willing donor but present this type of barriers. The first experiences of KPD in a single centre were carried out by creating large regional or national registries that increase the choice in difficult-to-match patients. Our experience shows that referring to the National Italian Registry for identifying a correct pair, allows performing KPD with good outcomes of LKD in cases that would otherwise not be feasible.