Kidney exchange programs: Attitudes of transplant team members toward living donation and kidney exchanges

Introduction. Several living donor kidney exchange programs (LDKEPs) have been established throughout the world; however, none have yet achieved the perceived substantial potential for increasing the number of living donor kidney transplants. Over the past 2 years, the Ohio Solid Organ Transplant Consortium (OSOTC) has developed and implemented an LDKEP with a complementary, robust web-based computerized matching program for living donor/recipient pairs. Prior to implementation of the OSOTC LDKEP, attitudes of transplant professionals from each of eight participating kidney transplant programs were surveyed to determined attitudes toward living donation and LDKEP and to identify potential barriers to LDKEP. The state of decision making toward LDKEP was also examined. Methods. Transplant professionals were surveyed using an instrument designed to assess attitudes toward living donation and LDKEPs. Most questions were answered on a Likert scale (1 = strongly agree, 5 = strongly disagree). Results. Respondents agreed that living donor transplantation should be encouraged (mean 1.17 +/- 0.6) and that the laparoscopic donor procedure was preferred (1.36 +/- 0.82). Respondents had largely read about KEPs (2.02 +/- 1.02) but had "thought about participating in KEPs" (2.57 +/- 1.26), or actively sought information (2.87 +/- 1.3) to lesser degrees. Despite this, significant indecisiveness existed regarding participation in LDKEPs (2.73 +/- 1.39). Conclusions. Transplant professionals are highly aware of LDKEPs. However, they remain indecisive about LDKEP participation. These results indicate that barriers exist in the transplant community toward LDKEP, and these must be defined to increase LDKEP acceptance and participation.