A new programme to increase the possibilities for kidney transplantation: Padua sets an example worldwide

The paper presenting the results of six years of the Italian DEC-K programme (Deceased Donor Initiated Kidney Paired Exchange) has been published in the international journal American Journal of Transplantation: an innovative model that for the first time in the world integrates living donation and donation from deceased donors.

The protocol stems from a pioneering idea by Lucrezia Furian, Unipd professor and director of the UOC Kidney and Pancreas Transplant Surgery at the Azienda Ospedale Università Padova, which was initially developed at the Centro Trapianti di Padova, but was subsequently extended nationwide thanks to collaboration with the Centro Nazionale Trapianti and numerous other Italian centres.

The idea is simple, yet revolutionary: to use a kidney from a deceased donor to unlock and initiate a chain of transplants among incompatible donor-recipient pairs, so that the final kidney from a living donor in the chain is returned to the waiting list. The results clearly demonstrate the strength of this insight: 34 DEC-K chains (deceased donor-initiated paired exchange) made it possible to carry out 84 kidney transplants, with an average of 2.5 transplants for each chain initiated and long-term outcomes comparable to those achieved with living donor transplantation.

The study, of which Furian is senior author, represents the world’s first long-term analysis of a national kidney paired donation programme initiated by a deceased donor. This result shows how an innovation born in Padua can, through collaboration with other centres and different institutions, become a national strategy capable of concretely expanding transplant opportunities, particularly for patients who are more difficult to transplant for immunological reasons and for whom the search for a compatible organ is highly complex.

Lucrezia Furian emphasises: "The project arose from the meeting point between research, innovation and clinical practice, with the idea of overcoming the limits of traditional models and making the best possible use of available resources: an approach that places at its centre not only technology, but above all collaboration among professionals and the ability to build more efficient and personalised pathways. Starting from Padua, this insight truly proposes a change in perspective: turning a complex challenge, namely the current shortage of available organs, into an opportunity to rethink the transplant system. A model that can help to broaden the pool of eligible patients and reduce waiting times. It is a story of innovation born locally, but with potential that goes beyond the boundaries of Padua and the Veneto region: an example of how research and expertise can be translated into innovative solutions capable of having a real impact on people’s lives. A project that became a reality thanks to perfect synergy with the Centro Nazionale Trapianti".