Donors and recipients are in perfect condition and have already been discharged. The Spanish couple is made up of mother and son, while the Italian is a marriage.

Both renal extractions and transplants were performed the same day, last October 22, in the Puigvert Foundation from Barcelona, ​​a reference center in renal transplantation and the Padova Kidney Transplant in Italy.

The cross-kidney transplant program is based on the exchange of live kidney donors between 2 or more couples. Its objective is to offer patients with chronic renal failure the possibility of receiving a live donor graft, even though their partner or family member, who wishes to make the donation effective, is incompatible.

This type of transplant involves a complicated logistic process, which has required full collaboration between the headquarters of the national transplant organizations in Spain and Italy, the regional and / or regional transplant coordinators (the Catalan Transplant Organization, OCATT, in the Spanish case) and the medical teams of the 2 hospitals that have participated in this operation. In the Puigvert Foundation, the medical team was made up of doctors Alberto Breda, head of the renal transplant surgical team, Luis Guirado, head of the nephrology service, Carme Facundo, attached to the nephrology service, and Joan Palou, director of the urology.

In the second successful crossing of the international cross-kidney transplant program, 18 hospitals have participated: 10 Spanish, 7 Italian and 1 Portuguese (See attached table) and 129 donor-recipient couples. Of these, 81 Spanish, 27 Italian and 21 Portuguese.

The cross-kidney transplant program is one of the modalities of living donor renal transplantation, which the ONT launched in our country a decade ago, after developing, in collaboration with a multidisciplinary working group, a joint work protocol. The first cross-kidney transplant was carried out in Spain in July 2009. Since then, in our country, within the national program, 228 transplants of this type have been performed, a figure that rises to 230 if the 2 carried out within the international program

Cross-renal transplantation is a highly developed therapeutic modality in certain countries with a high level of renal donor kidney transplant activity. This is the case in Australia, Canada, South Korea, the United States, the Netherlands or the United Kingdom, which have been carrying out this type of intervention for some time with excellent results.

The use of increasingly less invasive surgical techniques and the study and care of the donor (before, during and after the intervention) have allowed this type of transplant to be enhanced, given that the possible complications for the donor have diminished considerably and currently the Renal extraction of live is considered a low-risk procedure.

Partner Registration

It was precisely Spain, through the ONT, who promoted the creation of the International Cross-Kidney Transplant Program, among the countries that make up the Southern Transplant Alliance (Spain, France, Italy, Portugal, Czech Republic and Switzerland). Both in the first and in the second successful crossing have participated together with Spain, Italy and Portugal.

A fundamental aspect of the program is the Donor-Recipient Partner Registry, which needs a computer application to make the crossings and quickly know their results.

The program must be supervised by the person in charge of the national cross-donation programs in each participating country: in this case, Italy, Portugal and Spain.

With the internationalization of the crossed renal transplant, it is sought to increase the chances that couples have of finding a compatible donor and being able to exchange the organs of their donors. The more couples participating in it and the greater its genetic heterogeneity, the greater the options of making donation and renal exchange effective.

Other countries in northern and central Europe work in the same direction.

The ONT coordinates the process

The ONT, which has coordinated this operation at all times, has contributed its experience and the computer platform that allows analyzing the possibilities of exchange between couples registered in the International Registry.

The ONT is also responsible for managing the crossings of couples, adequately informing participating countries about the possible combinations detected after each crossing and developing an annual report on the results. To achieve this goal, a secure web platform was created based on the ONT cross-kidney donation software, which contains information on all donor-recipient couples. This platform is located in the ONT and its staff is responsible for its maintenance and administration.

Participating hospitals by countries

Ministry of Health, Consumption and Social Welfare

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