Abstract
Kidney paired donation (KPD) is an efficient strategy to circumvent major immunological barriers in patients who have a willing and medically able, but incompatible living donor. In recent years, several countries have developed successful KPD programs, including highly active multicenter alliances in the United States, and even international cross-border kidney shipment has been documented.
In Europe, several countries are running independent KPD programs, with the Dutch program being the most prominent. Smaller programs, such as in the Czech Republic and in Austria; however, are limited by small KPD pools (<=10 pairs per match run).
Over the last 5 years, 49 successful KPD transplants have been performed in Prague (3-monthly match runs including both ABO and HLA antibody-incompatible pairs), and, in the last 3 years, a smaller number in Vienna (n = 8), where ABO-incompatible pairs are not primarily included. Unfortunately, match rates have now substantially decreased due to growing proportions of broadly sensitized candidates.