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. 2019 Jul;103(7):1514-1522.
doi: 10.1097/TP.0000000000002432.

Building Kidney Exchange Programmes in Europe-An Overview of Exchange Practice and Activities

Péter Biró  1 , Bernadette Haase-Kromwijk  2 , Tommy Andersson  3 , Eyjólfur Ingi Ásgeirsson  4 , Tatiana Baltesová  5 , Ioannis Boletis  6 , Catarina Bolotinha  7 , Gregor Bond  8 , Georg Böhmig  8 , Lisa Burnapp  9 , Katarína Cechlárová  10 , Paola Di Ciaccio  11 , Jiri Fronek  12 , Karine Hadaya  13 , Aline Hemke  2 , Christian Jacquelinet  14 , Rachel Johnson  9 , Rafal Kieszek  15 , Dirk R Kuypers  16 , Ruthanne Leishman  17 , Marie-Alice Macher  14 , David Manlove  18 , Georgia Menoudakou  19 , Mikko Salonen  20 , Bart Smeulders  21 , Vito Sparacino  11 , Frits C R Spieksma  16 , María Oliva Valentín  22 , Nic Wilson  23 , Joris van der Klundert  24 ; ENCKEP COST Action
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Building Kidney Exchange Programmes in Europe-An Overview of Exchange Practice and Activities

Péter Biró et al. Transplantation. 2019 Jul.

Abstract

Background: Considerable differences exist among the living donor Kidney Exchange Programmes (KEPs) that are in use and being built in Europe, contributing to a variation in the number of living donor transplants (Newsletter Transplant; International figures on donation and transplantation 2016). Efforts of European KEPs to exchange (best) practices and share approaches to address challenges have, however, been limited.

Methods: Experts from 23 European countries, collaborating on the European Network for Collaboration on Kidney Exchange Programmes Cooperation on Science and Technology Action, developed a questionnaire to collect detailed information on the functioning of all existing KEPs in Europe, as well as their opportunities and challenges. Following a comparative analysis, results were synthesized and interpreted by the same experts.

Results: The practices, opportunities and challenges reported by 17 European countries reveal that some of the 10 operating programs are mature, whereas others are in earlier stages of development. Over 1300 transplants were performed through existing KEPs up to the end of 2016, providing approximately 8% of their countries' living kidney donations in 2015. All countries report challenges to either initiating KEPs or increasing volumes. Some challenges are shared, whereas others differ because of differences in context (eg, country size, effectiveness of deceased donor program) and ethical and legal considerations (eg, regarding living donation as such, nonrelated donors, and altruistic donation). Transnational initiatives have started in Central Europe, Scandinavia, and Southern Europe.

Conclusions: Exchange of best practices and shared advancement of national programs to address existing challenges, aided by transnational exchanges, may substantially improve access to the most (cost) effective treatment for the increasing number of patients suffering from kidney disease.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Development of KEPs by country.
FIGURE 2.
FIGURE 2.
KEP activity: number of proceeding transplants and the number of new recipients registered in 2015 by country.
See this image and copyright information in PMC

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