TY - JOUR
T1 - Scandiatransplant Exchange Program (STEP)
T2 - Development and Results From an International Kidney Exchange Program
AU - Duus Weinreich, Ilse
AU - Andersson, Tommy
AU - Birna Andrésdóttir, Margrét
AU - Bengtsson, Mats
AU - Biglarnia, Alireza
AU - Bistrup, Claus
AU - Boulland, Line
AU - Bruunsgaard, Helle
AU - Helanterä, Ilkka
AU - Kölvald, Kulli
AU - Lauronen, Jouni
AU - Lindahl, Jørn Petter
AU - Skov, Karin
AU - Schwarz Sørensen, Søren
AU - Wennberg, Lars
AU - Lindner, Per
N1 - Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
PY - 2023/11
Y1 - 2023/11
N2 - BACKGROUND: Kidney transplant candidates may be incompatible with their intended living donors because of the presence of antibodies against HLA and/or ABO. To increase the possibility of finding an acceptable kidney donor for these patients, the Scandiatransplant Exchange Program (STEP) program within Scandiatransplant was launched in 2019.METHODS: This is a retrospective review of our experiences from the first 4 y of the STEP program, including details about the match runs, performed transplantations, and recipient outcomes within the program.RESULTS: During 2019-2022, 11 match runs and 4 reruns were performed. In total, 114 pairs and 6 anonymous donors participated in these match runs. Fifty-one pairs (45%) participated in 1 match run, 31 pairs (27%) participated in 2 match runs, and 32 pairs (29%) participated in ≥3 match runs. Seventy-two individuals (63%) participated because of HLA incompatibility, 19 (17%) because of ABO incompatibility, and 7 (6%) because of both HLA and ABO incompatibility.Forty percent of the patients enrolled in the program underwent transplantation. In total, 49 transplantations have so far been performed within the program, and 46 (94%) of the recipients had a functioning kidney graft at follow-up in February 2023.CONCLUSIONS: The STEP program offers sensitized patients an enlarged pool of living donors and a chance of a compatible international living donor, resulting in an increased number of total transplantations. Currently, STEP is one of the largest transnational kidney exchange programs and has improved the situation for patients waiting for kidney transplantation in Scandiatransplant.
AB - BACKGROUND: Kidney transplant candidates may be incompatible with their intended living donors because of the presence of antibodies against HLA and/or ABO. To increase the possibility of finding an acceptable kidney donor for these patients, the Scandiatransplant Exchange Program (STEP) program within Scandiatransplant was launched in 2019.METHODS: This is a retrospective review of our experiences from the first 4 y of the STEP program, including details about the match runs, performed transplantations, and recipient outcomes within the program.RESULTS: During 2019-2022, 11 match runs and 4 reruns were performed. In total, 114 pairs and 6 anonymous donors participated in these match runs. Fifty-one pairs (45%) participated in 1 match run, 31 pairs (27%) participated in 2 match runs, and 32 pairs (29%) participated in ≥3 match runs. Seventy-two individuals (63%) participated because of HLA incompatibility, 19 (17%) because of ABO incompatibility, and 7 (6%) because of both HLA and ABO incompatibility.Forty percent of the patients enrolled in the program underwent transplantation. In total, 49 transplantations have so far been performed within the program, and 46 (94%) of the recipients had a functioning kidney graft at follow-up in February 2023.CONCLUSIONS: The STEP program offers sensitized patients an enlarged pool of living donors and a chance of a compatible international living donor, resulting in an increased number of total transplantations. Currently, STEP is one of the largest transnational kidney exchange programs and has improved the situation for patients waiting for kidney transplantation in Scandiatransplant.
UR - http://www.scopus.com/inward/record.url?scp=85175238332&partnerID=8YFLogxK
U2 - 10.1097/TXD.0000000000001549
DO - 10.1097/TXD.0000000000001549
M3 - Journal article
C2 - 37854025
SN - 2373-8731
VL - 9
SP - e1549
JO - Transplantation Direct
JF - Transplantation Direct
IS - 11
ER -