Advancing Organ Exchange Programs: Progress and Challenges
The content explores the progress of organ exchange programs within Scandiatransplant, detailing match runs, results, and country statuses as of September 2020. It also covers prioritization rules and challenges faced, such as broken cycles and reasons for them. The data provides insights into the success and ongoing efforts of these programs.
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Presentation Transcript
STEP STEP Ilse D. Weinreich Ilse D. Weinreich
STEP match runs within Scandiatransplant 1st STEP match run April 9th, 2019 4 x 3-way exchanges 1 x 2-way exchanges Which meant that 14 of the 20 pairs came out in a match cycle 2nd match run June 20th, 2019 1 x 3-way exchanges (w. nested 2-way) 1 x 2-way exchanges Which meant that 5 of the 16 pairs included came out in a match cycle 3rd match run October 29th, 2019 1 x 3-way exchange 2 x 2-way exchanges Which meant that 7 of the 18 pairs included came out in a match cycle
STEP match runs 4th match run January 28th, 2020 2 x 3-way exchanges 2 x chains both including one altruistic donor and two pairs 2 x 2-way exchanges Which meant that 2 of 2 altruistic donors and 14 of the 20 pairs included in the run came out in a match cycle/chain. 5th match run September 1st, 2020 3 x 3-way exchanges 1 x chain including one altruistic donor and two pairs 2 x 2-way exchanges Which meant that 1 of 1 altruistic donor and 15 of the 27 pairs included in the run came out in a match cycle/chain Re-run after 5th match run, September 11th, 2020 1 x 3-way exchange Which means that 3 of the 17 pairs included in the re-run came out in a match cycle
Results, so far 23 cycles/chanis in total 8 cycles/chains have let to 18 pairs being part of an exchange 11 cycles/chains have been broken 4 cycles/chains are under evaluation Reason for broken cycles: 1, lack of communication 1, pair changed decision 6, immunological reasons (2 DSA (1 new, 1 historical), 2 non-bead data, 2 ABO titer) 1, registration error 2, Covid-19 1, ? Around 50% proceeding (23 actual cycles/(8 cycles performed + 4 being evaluated)
Status from each country as of Sept. 2020 Country Status Denmark All centers have enrolled pairs into the program and participated in 6 match runs Estonia Not ready to participate, the general public attitude towards health care is under pressure at the moment Finland Ready to participate. Entering data on their first pair, plan to participate in next match run Iceland Ready to participate. Not yet decided on logistics Norway Ready to participate. Working on information material and logistics, however still legal issues and waiting for their IT-depatment (Fusion to YASWA transfer) Sweden All centers have enrolled pairs into the program and participated in 6 (+2) match runs
Prioritization rules, simulations? 1. The number of transplanted patients 2. Short cycles 3. Low match probability 4. Compatible blood groups, the number of ABO-incompatible transplants should be minimized in each match run Strict priorities or weight scores? currently strict priorities In contact with European working group, online meeting Sept. 29,2020
