Non-Simultaneous Transplants Can Increase Kidney Donation

Report describes how an altruistic donor triggered a series of 10 transplants in 2007-2008

WEDNESDAY, Mar. 11 (HealthDay News) -- A series of 10 kidney transplantations initiated by a single altruistic donor demonstrates the potential of such chains to increase the number of transplantations and improve donor-recipient matches, according to a report published in the Mar. 12 issue of the New England Journal of Medicine.

Michael A. Rees, M.D., PhD., from the Toledo Medical Center in Toledo, Ohio, and colleagues report on 10 kidney transplants that began with a single altruistic donor in July 2007. The donations were arranged by two large registries during an eight-month period. The donor and the recipient underwent surgery simultaneously in five of the 10 transplantations. The other five transplants did not happen simultaneously, therefore, showing promise for this strategy of a chain of transplants, the researchers report.

Because of the risk of a donor reneging, it has been practice for kidney transplantations involving multiple donors and recipients to be done simultaneously, which effectively limits the number of procedures, the researchers note. However, an altruistic kidney donor -- that is, one with no designated recipient -- can provide the organ to trigger a string of non-simultaneous transplantations drawn from a large donor pool using a selection algorithm to find matches for blood type, human leukocyte antigen (HLA), and personal and logistical factors, such as travel time. The strategy, known as a non-simultaneous, extended, altruistic-donor (NEAD) chain, also reduces reliance on deceased donor organs, the authors add.

"In addition to increasing the quantity of living-donor transplantations, NEAD chains may improve the quality of the matches," Rees and colleagues write.

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