Scandiatransplant Exchange Program (STEP): Development and Results From an International Kidney Exchange Program.

IF 1.9 Q3 TRANSPLANTATION Transplantation Direct Pub Date : 2023-10-16 eCollection Date: 2023-11-01 DOI:10.1097/TXD.0000000000001549

Ilse Duus Weinreich, Tommy Andersson, Margrét Birna Andrésdóttir, Mats Bengtsson, Alireza Biglarnia, Claus Bistrup, Line Boulland, Helle Bruunsgaard, Ilkka Helanterä, Kulli Kölvald, Jouni Lauronen, Jørn Petter Lindahl, Karin Skov, Søren Schwarz Sørensen, Lars Wennberg, Per Lindner

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Abstract

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.

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扫描移植物交换计划（STEP）：国际肾脏交换计划的发展和结果。

背景：由于存在针对HLA和/或ABO的抗体，肾移植候选者可能与其预期的活体捐赠者不相容。为了增加为这些患者找到可接受的肾脏捐献者的可能性，Scandiatransplant中的Scandiatransparent Exchange Program（STEP）计划于2019年启动。方法：这是对我们在STEP计划前四年的经验的回顾性回顾，包括该计划中匹配运行、移植和接受者结果的详细信息。结果：在2019-2022赛季，共进行了11场比赛和4次重播。总共有114对和6名匿名捐赠者参加了这些比赛。51对（45%）参加了1场比赛，31对（27%）参加了2场比赛，32对（29%）参加了≥3场比赛。72人（63%）因HLA不相容而参与，19人（17%）因ABO不相容而参加，7人（6%）因HLA和ABO不兼容而参加。参与该项目的患者中有40%接受了移植。到目前为止，该计划共进行了49次移植，其中46名（94%）受试者在2023年2月的随访中接受了功能正常的肾移植。结论：STEP计划为致敏患者提供了更多的活体捐赠者，并有机会获得兼容的国际活体捐赠者，从而增加了总移植数量。目前，STEP是最大的跨国肾脏交换项目之一，改善了Scandiatransplant中等待肾脏移植的患者的状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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