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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]

Author

Listed:
  • Julien Combe

    (X - École polytechnique - IP Paris - Institut Polytechnique de Paris)

  • Victor Hiller

    (Université Paris-Panthéon-Assas, LEMMA - Laboratoire d'économie mathématique et de microéconomie appliquée - Université Paris-Panthéon-Assas)

  • 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 des Ponts ParisTech - 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])

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.

Suggested Citation

  • Julien Combe & Victor Hiller & Olivier Tercieux & Benoît Audry & Jules Baudet & Géraldine Malaquin & François Kerbaul & Corinne Antoine & Marie-Alice Macher & Christian Jacquelinet & Olivier Bastien &, 2022. "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]," PSE-Ecole d'économie de Paris (Postprint) hal-03843902, HAL.
    • Handle: RePEc:hal:pseptp:hal-03843902
    DOI: 10.1016/j.nephro.2022.02.001
    Note: View the original document on HAL open archive server: https://hal.science/hal-03843902v1
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    References listed on IDEAS

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    1. Constantino, Miguel & Klimentova, Xenia & Viana, Ana & Rais, Abdur, 2013. "New insights on integer-programming models for the kidney exchange problem," European Journal of Operational Research, Elsevier, vol. 231(1), pages 57-68.
    2. Julien Combe & Victor Hiller & Olivier Tercieux & Benoît Audry & Yinghua He & Christian Jacquelinet & Marie-Alice Macher, 2019. "Perspectives sur le programme de dons croisés de reins en France," Institut des Politiques Publiques halshs-02516419, HAL.
    3. Vicky Mak-Hau, 2017. "On the kidney exchange problem: cardinality constrained cycle and chain problems on directed graphs: a survey of integer programming approaches," Journal of Combinatorial Optimization, Springer, vol. 33(1), pages 35-59, January.
    4. Julien Combe & Victor Hiller & Olivier Tercieux & Benoît Audry & Yinghua He & Christian Jacquelinet & Marie-Alice Macher, 2019. "Perspectives sur le programme de dons croisés de reins en France," Post-Print halshs-02516419, HAL.
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