Analysis of kidney and liver exchange transplantation in India (2000–2025): a multicentre, retrospective cohort study

作者：Vivek Kute, Himanshu V. Patel, Subho Banerjee, Feroz Aziz, Suraj Godara, Shyam Bihari Bansal, Anil Kumar Bhalla, Pranjal Modi, Ashish Sharma, Viswanath Billa, Sajith Narayanan, Priyadarshi Ranjan, Manish Singla, Arvinder S. Soin, Subhash Gupta, Sandeep Guleria, Prashant Bhangui, Ankur Gupta, Deepak Shankar Ray, Divyesh P. Engineer, Jamal Rizvi, Vishal Parmar, Madan M. Bahadur, Sarbpreet Singh, Ashay Shingare, Bharat Shah, Benil Hafeeq, Ismail N Aboobacker, Shriganesh R. Barnela, Munish Chauhan, Santosh Varughese, Dinesh Khullar, Mohamed Rela, Jatin Kothari, Shrirang Bichu, Dinesh Kumar, Pratik Das, Jyotish Chalil Gopinathan, Jeethu Joseph Eapen, Sushree Sashmita Das, Sunil Prakash, Anil Kumar, Shriniwas Ambike, Ravi Angral, Sanjiv Saxena, Suhas Bavikar, Vidyanand Tripathi, Sanjay Srinivasa, Umapati Hegde, Vishwanath Siddini, Nisith Mohanty, Kim Mammen, Abi Abraham M, Divya Bajpai, Sanshriti Chauhan, Anil Kumar, Manish Balwani, Hari Shankar Meshram, Ravi Mohanka, Surendran Sudhindran, Gaurav Chaubal, Srinivasan Thiagarajan, Ashwin Rammohan, Vineet Mishra, Sharmila Thukral, Purva Bavikar, Tukaram Jamale, Jai Kriplani, N.S. Girish, Kamlesh Parikh, Tarun Jeloka, Vinugopal Sreekumar, Sarfaraz Aslam, Veerbhadra Guptha, Dhananjai Agarwal, Sanjeev Gulati, Akash Gupta, M. Kamal Kiran, Urmila Anandh, Manoj Gumber, Prawash Kumar Chowdhary, Prakash Khetan, K.S. Nayak, Rushi Deshpande, Umesh Godhani, Sainath Pattewar, Kalpana Mehta, Neeraj Inamdar, Raj K. Yadav, Jigar Shrimali, Jitendra Goswami, Rajesh Garsa, R. Balasubramaniyam, Kamal Kiran Mukkavilli, Rajkumar K. Sharma, Sachin Soni, Imtiyaz Wani, Shailesh Kakde, Narayan Prasad, Ghanshyam Singh, Renuka Soni, Anushka Shankar, M.S. Gireesh, Aneesh Srivastava · 发表于：The Lancet Regional Health - Southeast Asia · 年份：2025 · DOI：10.1016/j.lansea.2025.100597 · 被引用次数：8 · 研究领域：Organ Donation and Transplantation、Renal Transplantation Outcomes and Treatments、Organ Transplantation Techniques and Outcomes

Background: In India, where deceased organ donation rates are relatively low, living donor transplantation programmes face challenges due to ABO incompatibility and sensitisation. Approximately one-third of healthy, willing living donors are incompatible with their intended recipients due to these factors. No large-scale data are currently available on kidney exchange (KE) or liver exchange (LE) transplants in low- and middle-income countries, including India. Methods: We conducted a multicentre, retrospective cohort study including KE (2000-2024) from 65 centres and LE (2007-2025) from 7 centres across India. The living donors were near-related donors without altruistic and deceased donors. Demographic and clinical data of both donors and recipients were included in the study. The reasons for KE/LE, post-transplant outcomes with respect to patient and graft survival, rejection episodes, and donor outcomes were analysed. Kidney allocation system guidelines were: (i) Thorough pre-transplant work-up of DRP was completed before allocation to avoid chain collapse. (ii) A policy of non-anonymous allocation was practised (in contrast to anonymous allocation in high-income countries), where pairs can create a rapport during evaluation and surgery. (iii) Simple two-way exchanges, and simultaneous surgeries were considered for less experienced transplant centres in order to avoid donor renege. Findings: A total of 1839 KE and 259 LE transplants were included in the study. The distribu...