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Paired Kidney Exchange Update. October 13, 2012 Karen M. Miller. National Kidney Registry Why Does it Work?. Over 60 centers have joined 538 transplants to date 308 active donors in the pool Match runs completed daily. Simultaneous Domino Paired Donation
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Paired Kidney Exchange Update October 13, 2012 Karen M. Miller
National Kidney RegistryWhy Does it Work? • Over 60 centers have joined • 538 transplants to date • 308 active donors in the pool • Match runs completed daily
Simultaneous Domino Paired Donation (DPD) Nonsimultaneous Extended Altruistic Donor Chains (NEAD) NEAD NDD R R Cluster #1 D R D R D D R R BD R D R Cluster #2 D R D WL D R BD R Cluster #3 D Etc. .
Children and High PRA (CHIPS) • Children--No living donor • Adult--WL > 3 years, Highly sensitized, past donor, on dialysis • ABO = A, B, AB with greatest chance • Max 50 patients
Pair Match Power • Pair Match Power is the key to understanding wait time • Pair Match Power (PMP) is the most accurate predictor of paired exchange wait time and should be used by patients and clinicians to develop individual matching strategies for pairs
Rule of Thumb • If PMP=400+ Pair will match immediately • If PMP>200 Pair is easy to match • If PMP<100 Pair is hard to match • If PMP=0 Pair nearly impossible to match
UW Update • Joined NKR 12/2010 • 1st paired exchange 2/2011 • 17 transplants in 2011 • 14 transplants in 2012 (as of 9/24/12) • 4 non directed donors in 2012 (9 in 2011) • 5 highly sensitized patients transplanted with no desensitization PRA > 85%
18 pairs active • 45 CHIP active • 6 active chains • Two chains with three pairs scheduled
In Summary • Paired Kidney Exchange works • Gives hope to highly sensitized patients • Able to use good and willing donors • Able to better inform patients r/t PMP • Many highs and lows