Perspectives for future development of the kidney paired donation programme in France

Perspectives pour une évolution du programme de don croisé de reins en France

Julien Combe, Victor Hiller, Olivier Tercieux (), Benoît Audry, Jules Baudet, Géraldine Malaquin, François Kerbaul, Corinne Antoine, Marie-Alice Macher, Christian Jacquelinet, Olivier Bastien and Myriam Pastural
Additional contact information
Olivier Tercieux: PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École nationale des ponts et chaussées - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Benoît Audry: Agence de la biomédecine [Saint-Denis la Plaine]
Jules Baudet: X - École polytechnique - IP Paris - Institut Polytechnique de Paris
Géraldine Malaquin: Agence de la biomédecine [Saint-Denis la Plaine]
François Kerbaul: Agence de la biomédecine [Saint-Denis la Plaine]
Corinne Antoine: Agence de la biomédecine [Saint-Denis la Plaine]
Marie-Alice Macher: Agence de la biomédecine [Saint-Denis la Plaine]
Christian Jacquelinet: Agence de la biomédecine [Saint-Denis la Plaine]
Olivier Bastien: Agence de la biomédecine [Saint-Denis la Plaine]
Myriam Pastural: Agence de la biomédecine [Saint-Denis la Plaine]

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Abstract: Almost one third of kidney donation candidates are incompatible (HLA and/or ABO) with their directed recipient. Kidney paired donation allows potential donors to be exchanged and gives access to a compatible kidney transplant. The Bioethics Law of 2011 authorised kidney paired donation in France with reciprocity between 2 incompatible "donor-recipient" pairs. A limited number of transplants have been performed due to a too restricted authorization compared to other European practices. This study presents the perspectives of the new Bioethics Law, enacted in 2021, which increases the authorised practices for kidney paired donation in France. The two simulated evolutions are the increase of the number of pairs involved in a kidney paired donation to 6 (against 2 currently) and the use of a deceased donor as a substitution to one of living donor. Different scenarios are simulated using data from the Agence de la Biomedecine; incompatible pairs registered in the kidney paired donation programme in France between December 2013 and February 2018 (78 incompatible pairs), incompatible transplants performed during the same period (476 incompatible pairs) and characteristics of deceased donors as well as proposals made over this period. Increasing the number of pairs has a limited effect on the number of transplants, which increases from 18 (23% of recipients) in the current system to 25 (32% of recipients) when 6 pairs can be involved. The use of a deceased donor significantly increases the number of transplants to 41 (52% of recipients). This study makes it possible to evaluate the increase in possibilities of kidney transplants by kidney paired donation following the new bioethics law. A working group and an information campaign for professionals and patients will be necessary for its implementation.

Keywords: Bioethics law; Kidney exchange programme; Kidney paired donation; Living donor chain; Living donor kidney transplantation; Don croisé; Programme d'échange croisé; Chaine de donneur vivant; Transplantation rénale à donneur vivant; Loi de Bioéthique (search for similar items in EconPapers)
Date: 2022
Note: View the original document on HAL open archive server: https://hal.science/hal-03843902v1
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Published in Néphrologie & Thérapeutique, 2022, 18 (4), pp.270-277. ⟨10.1016/j.nephro.2022.02.001⟩

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Working Paper: Perspectives for future development of the kidney paired donation programme in France (2022)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03843902

DOI: 10.1016/j.nephro.2022.02.001

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