BACKGROUND: Kidney paired donation (KPD) programs are mainly used to facilitate transplantation for candidates with ABO or HLA incompatible living donors. However, the benefit of KPD for transplant candidates with HLA and ABO living compatible donors (compatible pairs) is unknown. We aimed to quantify the benefits of enrolling compatible pairs into KPD.

METHODS: We performed a retrospective cohort study of kidney transplant recipients who were enrolled in the Mayo-3 site KPD program (Mayo Clinic- Rochester, Arizona, and Florida). Using matched paired analysis and t-tests we compared the original and actual donor characteristics among recipients who were enrolled into KPD with a HLA/ABO compatible donor.

RESULTS: From 9/2007 – 10/2017, 280 individuals were transplanted through KPD, and 16.7% (47/280) were entered for reasons other than HLA/ABO incompatibility [CMV mismatch (N=5), EBV mismatch (N=5), age/size mismatch (n=24) and altruistic reasons (N=13)]. All of the compatible pairs facilitated exchanges for at least one HLA/ABO incompatible pair. The median time from KPD entry to transplant was 2.3 (IQR 1.1, 4.1) months for compatible pairs, and the actual donors were younger in comparison to original donors for this group [median 14.5 (IQR-2.3, 4.5) years younger, p<0.0001] Table 1. Recipients who entered KPD for reasons other than HLA/ABO incompatibility also benefited from an infectious disease standpoint, 44.0% (11/25) of the CMV negative recipients gained a CMV negative donor and 87.5% (7/8) of the EBV negative recipients with an EBV positive original donor gained an EBV negative donor.

CONCLUSION: Kidney transplant candidates with HLA and ABO compatible living donors can derive benefit from KPD while expanding the pool of potential donors for difficult to match candidates. Thus, KPD should be considered for all kidney transplant candidates with a living donor regardless of their HLA /ABO compatibility.

CITATION INFORMATION: Basu A., Kosberg C., Khamash H., Mai M., Prieto M., Schinstock C. The Advantage of Utilizing ABO and HLA Compatible Pairs in Kidney Paired Donation Am J Transplant. 2017;17 (suppl 3).

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