Karolinska University Hospital part of the first kidney transplant program across Scandinavia – Scandia Transplant Kidney Exchange Program (STEP)

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For the first time two kidney replacements have been performed involving donors and transplant patients who are part of the Scandinavian kidney exchange program STEP organized by Scandiatransplant.  The organization coordinates organ donations and transplants in Denmark, Estonia, Finland, Iceland, Norway and Sweden. During 2018 and 2019 Karolinska University Hospital performed and coordinated three STEP exchange programs with a total of six couples in cooperation with other hospitals in Sweden.

- The number of patients waiting for a new kidney in Sweden increased by more than 10% from 2018 to 2019, while the number of kidney transplants during the same period remained at the same level. The continued lack of organ donation from deceased donors often means that  waiting times are long, but with the kidney exchange program STEP  the possibilities for earlier kidney transplants from living donors have now increased Both kidney replacements performed during the autumn  involved two couples and  two other university hospitals in Scandinavia, says Lars Wennberg, Chief Physician and Patient Flow Manager Kidney Transplant at Theme Trauma and Reparative Medicine Karolinska University Hospital.

STEP enables exchange of kidneys between medically accepted but immunologically incompatible donor-recipient pairs. A donor who wants to help a relative that needs a kidney donates anonymously to another unknown person in need of a kidney. In exchange, the next of kin receives a kidney from another recipient's kidney donor. Kidney changes can take place between two or more participating couples.

- Today, a total of 2261 people in the six countries that are included in STEP are waiting for a new kidney compared with 2208 in 2018. The ability to carry out kidney changes between the different countries means that we can shorten waiting times says Bo-Göran Ericzon, Chairman of Scandiatransplant and Professor of Transplantation Surgery Theme Trauma and Reparative Medicine Karolinska University Hospital.

The necessary database to investigate immunological compatibility has been developed by Scandiatransplant, while the matching algorithm has been developed by Professor Tommy Andersson at the Department of Economics, Lund University in collaboration with Karolinska University Hospital. The algorithm is based on the Nobel Laureate in Economics Alvin Roth's research.

Background Scandiatransplant

Scandiatransplant is the organ exchange organization for the countries Denmark, Finland, Iceland, Norway, Sweden, and Estonia. It covers a population of about 28.2 million inhabitants. It is owned by the full member hospitals performing organ transplantation in these countries.  About 2000 patients are transplanted yearly within the Scandiatransplant association. Estonia became an associate member in 2017 http://www.scandiatransplant.org


  Sweden Denmark Norway Finland Iceland Estonia
Q 1-3 2018 2019 2018 2019 2018 2019 2018 2019 2018 2019 2018 2019
No of kidney transplantations 328 325 164 203 171 197 185 222 7 6 44 30
No of patients waiting for a kidney 664 730 545 519 480 492 472 475     47 45

Kim Sjölund
072-598 13 88                                  

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