Seventy-seven kidney paired donation transplantations at a single transplant centre in India led to an increase in living donor kidney transplantations in 2015.

BACKGROUND: To ascertain the validity of kidney paired donations (KPDs) as an alternative strategy for increasing living donor kidney transplantations (LDKTs) in an LDKT-dominated transplant programme since directed kidney transplantation, ABO-incompatible or crossmatch-positive pairs are not feasible due to costs and infectious complications.

METHODS: This was a prospective single-centre study of 77 KPD transplantations (25 two-way, 7 three-way and 1 six-way exchange) from 1 January 2015 to 1 January 2016 of 158 registered donor recipient pairs. During this period, a total of 380 kidney transplantations [71 deceased donor kidney transplantations (DDKTs), 309 LDKTs] were performed. The reasons for opting for KPD were ABO incompatibility ( n  = 45), sensitization ( n  = 26) and better matching ( n  = 6).

RESULTS: KPD matching was facilitated in 62% ( n  = 98) of transplants. In all, 48.7% ( n  = 77) of the transplants were completed in 2015, whereas 13.3% ( n  = 21) of the matched patients were to undergo transplant surgery in early 2016 after getting legal permission. The waiting time for KPD was shorter compared with DDKT. The death-censored graft survival and patient survival were 98.7% ( n  = 76) and 93.5% ( n  = 72), respectively. In all, 14.2% ( n  = 11) of patients had acute rejection. Match rates among sensitized ( n  = 60) and O group patients ( n  = 62) were 58.3% ( n  = 35) and 41.9% ( n  = 26), respectively. Of these, 43.3% ( n  = 26) and 29% ( n  = 18) of transplants were completed and 15% ( n  = 9) and 12.9% ( n  = 8), respectively, are waiting for legal permission.

CONCLUSIONS: LDKT increased by 25% in 1 year in our single-centre KPD programme. Our key to success was the formation of a KPD registry, awareness and active counselling programs and developing a dedicated team.