Quality System of Kidney Donation for Transplantation From Living Donors in Poland.

Abstract Objective The program aims to build and develop a high-quality donation system at the hospital and national level. Thirty coordinator posts for the transplantation of kidneys from living donors (LDs) were created. The coordinators’ tasks were identified as determining or excluding the possibility of LD donation for kidney transplantation for every potential kidney recipient referred to the waiting list, qualifying potential LDs, supervising health monitoring for LDs and kidney recipients, and education and promotion of transplantation from LDs. Methods The coordinators’ reports and verification of data in the national transplant register from June 1, 2018 to November 30, 2019 were analyzed. Ethics The study was conducted according to principles of the Declaration of Helsinki, and the Declaration of Istanbul participation was on a voluntary basis. Results Information on possible LDs was obtained from 707 (43%) of the 1630 potential recipients entered on the waiting list. In 373 cases there was no potential LD; 16 recipients did not give consent for kidney transplantation from a LD; for 318 recipients, 340 potential LDs were identified; 90 potential LDs were rejected at the initial stage for medical reasons; 60 potential donors were rejected at further stages of the qualification process; 3 persons resigned from donation; and 23 recipients were transplanted from deceased donors. Kidneys from 73 LDs were qualified and transplanted. On November 30, 2019, 91 potential donors were awaiting further qualification. As part of the program, 27 potential pairs for paired kidney exchange were reported to Poltransplant (17 pairs with positive HLA crossmatch, 10 with incompatible blood groups). Conclusions The creation of posts for coordinators for LD kidney transplantation in centers that qualify for LD kidney transplantation enabled systematic monitoring of donation potential, which led to an increase in the number of LD kidney transplants in 2019. Making full use of donation potential should significantly increase these numbers in the coming years.