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Friday, April 6, 2012

Transplant experts debate the creation of a nationwide registry for paired donations

The Daily Iowan | Jenny Earl

Health officials are looking to create a nationwide registry for kidney donations — and University of Iowa Hospitals and Clinics doctors are weighing the benefits.

Leaders in kidney transplant research announced last week that creating a nationwide registry used to oversee paired kidney donation would increase patient chances of receiving kidneys from live donors. Hospitals under the registry — such as the UIHC, which established its own in 2000 — would join with the programs of other hospitals.

"There's plusses and minuses to a national registry," said Alan Reed, the UIHC director of transplant and hepatobiliary surgery. "More people, more matches. But [there may be] less innovation and local interest and things like that."

In paired exchange donation, a transplant candidate with a willing donor who is incompatible can exchange donations with another candidate and her or his willing donor, providing a suitable match for each patient. Though it has been nearly a decade since the paired exchange program was created nationwide, there is currently no uniform system among hospitals for these exchanges.

According to the Scientific Registry of Transplant Recipients, about 9 percent of patients on kidney transplant waiting lists at UIHC and Iowa City VA Medical Center — where the same surgeons perform surgeries at both locations — received a kidney from a living donor from 2010 to 2011.

"Traditionally, [living transplant donations] have occurred when somebody has stepped forward to donate a kidney to a loved one," Reed said. "That's sort of a traditional way that they're done, given by a father — brother — that's still a huge bulk of how these transplants get done."

But Reed said a relatively small percent of transplants at the UIHC are done through paired donation.

Ken Andreoni, associate professor of surgery at Ohio State University — who attended the national conference that discussed creating the national unified program — said a national registry would mathematically increase the number of transplants in the long term.

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