Asynchronous, Out‐of‐Sequence, Transcontinental Chain Kidney Transplantation: A Novel Concept

@article{Butt2009AsynchronousOT,
  title={Asynchronous, Out‐of‐Sequence, Transcontinental Chain Kidney Transplantation: A Novel Concept},
  author={Fauzia K. Butt and H A Gritsch and Peter G. Schulam and Gabriel Danovitch and Alan H. Wilkinson and Joseph J. Del Pizzo and Sandip Kapur and David Serur and Steven Katznelson and Stephan Busque and Marc L. Melcher and Suzanne McGuire and Marian Charlton and Garet Hil and Jeffrey L. Veale},
  journal={American Journal of Transplantation},
  year={2009},
  volume={9}
}
The organ donor shortage has been the most important hindrance in getting listed patients transplanted. Living kidney donors who are incompatible with their intended recipients are an untapped resource for expanding the donor pool through participation in transplant exchanges. Chain transplantation takes this concept further, with the potential to benefit even more recipients. We describe the first asynchronous, out of sequence transplant chain that was initiated by transcontinental shipment of… 
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References

SHOWING 1-10 OF 26 REFERENCES
Exchange donor program in kidney transplantation.
TLDR
Living donors including related, unrelated, and exchange donors should be considered as potential donors for kidney transplantation to relieve the pressure on donor organ shortage in countries where brain death has not been socially or legally accepted.
Exchange living-donor kidney transplantation: diminution of donor organ shortage.
Successful Three‐Way Kidney Paired Donation with Cross‐Country Live Donor Allograft Transport
  • R. Montgomery, S. Katznelson, D. Segev
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2008
TLDR
This case provides a blueprint for solving some of the complexities that are inherent in the implementation of a national KPD program in a large country like the United States.
The Dutch National Living Donor Kidney Exchange Program
TLDR
The living donor kidney exchange program is a successful approach that does not harm any of the candidates on the deceased donor kidney waitlist and should be sustained for optimal results.
Clinical results from transplanting incompatible live kidney donor/recipient pairs using kidney paired donation.
TLDR
This series of patients who received transplants from a single-center KPD pool provides evidence that recipients with incompatible live donors, even those with rare blood type combinations or high degrees of HLA antigen sensitization, can receive transplants through KPD with graft survival rates that appear to be equivalent to directed, compatible live donor transplants.
Domino paired kidney donation: a strategy to make best use of live non-directed donation
Kidney paired donation and optimizing the use of live donor organs.
TLDR
The combination of a national KPD program and a mathematically optimized matching algorithm yields more matches with lower HLA disparity, and the health care system could save as much as $750 million.
The importance of innovative efforts to increase organ donation.
TLDR
The number of candidates annually on the waiting list for a deceased donor transplant has exceeded the number of available kidneys and waiting time has steadily lengthened, resulting in a small increase in deceased donor transplants in the United States in the last 2 years.
Cold Ischemia Time and Allograft Outcomes in Live Donor Renal Transplantation: Is Live Donor Organ Transport Feasible?
  • C. Simpkins, R. Montgomery, D. Segev
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2007
TLDR
Comparable long‐term outcomes for these grafts suggests that transport of live donor organs may be a feasible alternative to donor travel in KPD regions where CIT can be limited to 8 h.
A nonsimultaneous, extended, altruistic-donor chain.
TLDR
A chain of 10 kidney transplantations, initiated in July 2007 by a single altruistic donor and coordinated over a period of 8 months by two large paired-donation registries, illustrates the potential of this strategy.
...
...