Paired Exchange Kidney Transplantation Experience of Turkey

Abstract Objective Paired-exchange kidney transplantation (PKD) has gained in importance because of the difficulty to obtain suitable organs. The aim of this study was to compare the biochemical and clinical parameters of PKT with those of living-related kidney transplantation (LD). Method We compared 272 PKD performed in 3 transplant centers with 1885 LD. The 2 groups were compared for graft and patient survivals, rejection episodes, serum creatinine levels, and other biochemical parameters. Results The median human leukocyte antigen, mismatch was similar: PKD, 4 (95% confidence interval [CI], 3–4) and LD; 3 (95% CI, 3–4; P = .1292). The mean creatinine level among the PKT group of 1.07 ± .37 was lower then the LD group 1.17 ± .56 ( P = .0043), but after the second year it was lower in the LD group (1.39 ± 0.61 and 1.16 ± 0.43; P < .0001). The rates of patient death (PKT, 3.31% vs LD 3.58; P = .9603), graft loss (2.74% vs 2.71%; P = .8647) and acute rejection episodes (19.48% vs 19.36%; P = 0.9719), were similar between the 2 groups. Conclusions Paired donation expands the living donor pool and decreases the number of waiting list patients. It is cost effective according to ABO incompetible transplantation.