Increasing Kidney Transplant Availability: Live Donation, Paired Donation, and Transplant Across ABO and HLA Barriers

  • Lavjay Butani
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Living donor renal transplantation affords numerous benefits to the recipient and donor alike. However, living donor renal transplantation continues to lag behind deceased donor transplants in the USA for a variety of reasons. These include a lack of awareness among patients, patients’ families, health-care professionals, and the public about its benefits, sociocultural factors leading to mistrust of the health-care system, a significant financial burden on potential donors, and lastly biomedical factors that hinder living donation such as ABO/HLA incompatibility among donor-recipient dyads. Understanding the nuances of these barriers is critical in order to address and overcome them. This chapter explores these impediments and the strategies that are being employed to combat them and thereby increase living organ donation. Strategies discussed include ways to educate stakeholders about the logistics and the benefits of living donor renal transplantation, removing financial disincentives for organ donors, developing systems to enable donor exchanges and altruistic donation, and biomedical strategies to overcome the ABO/HLA incompatibility barrier.


Living donation Desensitization Intravenous immunoglobulin Plasmapheresis Immunoadsorption Rituximab Paired donor exchange 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric NephrologyUniversity of California Davis Children’s HospitalSacramentoUSA

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