A novel experience in living donor renal transplantation: voluntary exchange kidney transplantation.

Organ supply is an important problem worldwide with an ever-increasing number of patients on the waiting lists. Various strategies are implemented in the centers to increase the number of transplantations. Paired kidney exchange or nondirected organ donation to an exchange list is being performed for a while. However, the number of renal transplantations has failed to achieve the targeted levels. The present study aimed to provide information regarding 1-year outcomes of voluntary exchange kidney transplantation, which is performed in our center, and to raise awareness about the method. Compatible donor-recipient pairs and ABO-mismatched donor-recipient pairs were invited to participate in the model of voluntary exchange kidney transplantation. Of 42 donor-recipient pairs fulfilling the criteria, 22 (52.4%) accepted to participate in the model. In 4 of these 22 donor-recipient pairs, patients received a kidney transplant from their own donor due to the lack of another suitable donor on the waiting list. Thus, the remaining 18 donor-recipient pairs were included in the model of voluntary exchange kidney transplantation. Sixteen two-way, 1 three-way, and 1 four-way exchange kidney transplantations were performed. Thus, this provided 21 more patients an opportunity to have a renal transplant. Accordingly, the number of living donor transplantations performed in our center increased by 6.1% using this method. We anticipate that the number of patients on the waiting lists for transplantation would be decreased by the widespread use of voluntary exchange kidney transplantation.