The Role of Desensitization in Kidney Paired Donation

• Published in: Current transplantation reports 2019-12, Vol.6 (4), p.294-299
• Main Authors: Pham, Thomas, Lee, Lung-Yi, Melcher, Marc L.
• Format: Article
• Language: English
• Subjects: Immunology; Kidney Transplantation (M Henry and R Pelletier; Medicine; Medicine & Public Health; Section Editor; Surgery; Topical Collection on Kidney Transplantation; Transplant Surgery
• ISSN: 2196-3029; 2196-3029
• DOI: 10.1007/s40472-019-00261-2

Purpose of Review Kidney paired donation (KPD), desensitization, and prioritization in the deceased donor kidney allocation system (KAS) are current options to facilitate kidney transplant in difficult-to-match, highly sensitized patients. KPD participation has increased while new desensitization tools are developed. We review these trends and discuss the combined role of desensitization and KPD. Recent Findings According to the National Kidney Registry (NKR), KPD utilizing desensitization decreased while the number of highly sensitized KPD transplants and deceased donor transplants increased over the past decade. This is likely because of large KPD registries and the national allocation of deceased donor kidneys that allow highly sensitized patients to find compatible matches without the need for desensitization. Summary Highly sensitized patients with incompatible living donors should be entered into a KPD registry while simultaneously considered for deceased donor transplant. Those patients who do not find a compatible match within a year should be considered for desensitization.