Historical Matching Strategies in Kidney Paired Donation: The 7-Year Evolution of a Web-Based Virtual Matching System

被引：19

作者：

Fumo, D. E. ^{[1
,2
]}

Kapoor, V. ^{[2
]}

Reece, L. J. ^{[1
]}

Stepkowski, S. M. ^{[1
,2
]}

Kopke, J. E. ^{[1
]}

Rees, S. E. ^{[1
,2
]}

Smith, C. ^{[1
,2
]}

Roth, A. E. ^{[3
]}

Leichtman, A. B. ^{[4
]}

Rees, M. A. ^{[1
,2
]}

机构：

[1] Alliance Paired Donat, Maumee, OH 43537 USA

[2] Univ Toledo, Med Ctr, Dept Urol, Toledo, OH 43606 USA

[3] Stanford Univ, Dept Econ, Stanford, CA 94305 USA

[4] Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2015年 / 15卷 / 10期

基金：

美国国家科学基金会;

关键词：

CROSS-MATCH; NONSIMULTANEOUS CHAINS; EXCHANGE; PROGRAM; TRANSPLANTATION; EXPERIENCE; PREDICTION; NETWORK; DOMINOS; PHASE;

D O I：

10.1111/ajt.13337

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Failure to convert computer-identified possible kidney paired donation (KPD) exchanges into transplants has prohibited KPD from reaching its full potential. This study analyzes the progress of exchanges in moving from "offers'' to completed transplants. Offers were divided into individual segments called 1-way transplants in order to calculate success rates. From 2007 to 2014, the Alliance for Paired Donation performed 243 transplants, 31 in collaboration with other KPD registries and 194 independently. Sixty-one of 194 independent transplants (31.4%) occurred via cycles, while the remaining 133 (68.6%) resulted from nonsimultaneous extended altruistic donor (NEAD) chains. Thirteen of 35 (37.1%) NEAD chains with at least three NEAD segments accounted for 68% of chain transplants (8.6 tx/chain). The "offer'' and 1-way success rates were 21.9 and 15.5%, respectively. Three reasons for failure were found that could be prospectively prevented by changes in protocol or software: positive laboratory crossmatch (28%), transplant center declined donor (17%) and pair transplanted outside APD (14%). Performing a root cause analysis on failures in moving from offer to transplant has allowed the APD to improve protocols and software. These changes have improved the success rate and the number of transplants performed per year.

引用

页码：2646 / 2654

页数：9

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