Living donor paired-kidney exchange transplantation: A single institution experience

INTRODUCTION: Paired-kidney exchange (PKE) is used in western countries to increase donor pool. In India, there are not many centers involved in PKE program. We present 10 years of this experience and outcome of the recipients. MATERIALS AND METHODS: Between year 2000 and 2009, 34 transplants with PKE were performed. All donors were live related, and permission from Authorization committee(s) from one or more states was obtained prior to transplantation. Both donor and recipient surgeries were carried out simultaneously in all cases at a single institution. Last 10 donors were offered laparoscopic donor nephrectomy and all other previous donors were operated by open surgery. RESULTS: Five donor–recipient pairs were from the state of Rajasthan, one from Madhya Pradesh, and all others from Gujarat. ABO incompatibility between donor and recipient was present in 12 pairs and positive lymphocyte cross-match in 5 pairs. CONCLUSION: Paired-kidney-exchange transplantation expands donor pool and total number of transplantation.