Analysis of Broken Chains in Kidney Paired Donation During an 8 Year Period within the National Kidney Registry.
1Department of Urology, University of California - Los Angeles Medical Center, Los Angeles, CA
2National Kidney Registry, Babylon, NY.
Meeting: 2016 American Transplant Congress
Abstract number: 421
Keywords: Kidney transplantation
Session Information
Session Name: Concurrent Session: Kidney Paired Exchange: Outcomes and Issues
Session Type: Concurrent Session
Date: Tuesday, June 14, 2016
Session Time: 2:30pm-4:00pm
Presentation Time: 2:54pm-3:06pm
Location: Ballroom C
Purpose: Chain transplantation in kidney paired donation (KPD) offers the ability to facilitate multiple kidney transplants between incompatible pairs using a non-directed donor (NDD) to initiate the sequence. Concerns regarding donors' ability to back out have been previously raised yet few data exist which evaluate the frequency of broken chains due to donor issues. The purpose of this study was to evaluate the rate and cause of broken chains within a large KPD program.
Methods: All patients undergoing renal transplantation through the NKR from 2008 through Sept 2015 were included for analysis. Broken chains were defined as chains in which a donor did not undergo donor nephrectomy despite their intended recipient having received a kidney. Real time swap failures were evaluated as a subset of broken chains and defined as a chain which was broken on the day of the planned surgery. Loops (closed KPD sequences not initiated by a NDD) were also analyzed. Descriptive statistical analysis was performed.
Results: A total of 281 chains and 76 loops were completed during the study period yielding a total of 1,483 transplants. 19 broken chains (6.8%) and 1 broken loop (1.3%) were identified. The mean chain length (# of transplants) within broken chains was 4.05 compared to 4.69 of ended (completed) chains. Seven of the 19 broken chains were caused by real time swap failures. The most common causes of a broken chain were “medical” (n=8), “no reason” (n=4), and “kidney declined by recipient surgeon” (n=3). One “aborted donor surgery” and one “recipient medical issue” occurred. A donor “renege” occurred in 1 case.
Conclusions: Based on these results broken chains are infrequent and rarely due to a donor renege. The most common cause of broken chains within this KPD program was “medical”.
CITATION INFORMATION: Cowan N, Sinacore J, Gritsch H, Veale J. Analysis of Broken Chains in Kidney Paired Donation During an 8 Year Period within the National Kidney Registry. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Cowan N, Sinacore J, Gritsch H, Veale J. Analysis of Broken Chains in Kidney Paired Donation During an 8 Year Period within the National Kidney Registry. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/analysis-of-broken-chains-in-kidney-paired-donation-during-an-8-year-period-within-the-national-kidney-registry/. Accessed July 12, 2025.« Back to 2016 American Transplant Congress