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ORIGINAL ARTICLE
Year : 2021  |  Volume : 15  |  Issue : 4  |  Page : 338-342

First single-center five-way kidney exchange cycle in India


1 Department of Nephrology and Transplantation Sciences, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
2 Department of Transplantation Surgery, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
3 Department of Obstetrics and Gynecology, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India

Correspondence Address:
Dr. Vivek B Kute
Departments of Nephrology and Transplantation Sciences, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_69_21

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Objective: The logistical issues, limited resources, and surgical capacity are the challenges to simultaneous kidney exchange transplant surgeries in India. We report the first single-center 5-way nonsimultaneous kidney exchange cycle from India without donor renege. The challenges and solutions for the same are discussed. Methods: Five donor–recipient pairs (DRPs) participated in 5-way kidney exchange cycle after permission of Institutional and Gujarat State Level Authorization Committee for organ transplantation. Four DRP were ABO-incompatible and the fifth was compatible. Results: Two DRP were operated on November 22 and three on November 23, 2018. One bridge donor wait time was 1 day. All five recipients were discharged on November 30, 2018, without any medical or surgical complication; normal kidney allograft function and donor renege. We have increased chain length gradually from 2-way (June 2000), 3-way (February 2013), 4-way (April 2016), 5-way (November 2018), 6-way (February 2019), and 10-way (January 2020) in 440 kidney exchange transplants at our institute. We have used compatible pairs in gradually increasing chain length from 2-way (May 2012), 3-way (August 2013), 4-way (July 2018), 5-way (November 2018), and 6-way (February 2019) to increase transplant for difficult to match pairs. Conclusions: To the best of our knowledge, this is the first single-center 5-way kidney exchange cycle from India. Increasing chain length has the potential to offer better quality of matching and transplants rates for difficult-to-match pairs in kidney exchange.


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