A Nonsimultaneous, Extended, Altruistic-Donor Chain

TLDR

A 10‑kidney transplant chain, initiated by a single altruistic donor in July 2007 and coordinated over eight months by two paired‑donation registries, involved six centers across five states, with five transplants performed simultaneously and the remaining five extended via bridge donors up to five months later. The report demonstrates the feasibility and potential of non‑simultaneous, extended altruistic‑donor chains for kidney transplantation.

Abstract

We report a chain of 10 kidney transplantations, initiated in July 2007 by a single altruistic donor (i.e., a donor without a designated recipient) and coordinated over a period of 8 months by two large paired-donation registries. These transplantations involved six transplantation centers in five states. In the case of five of the transplantations, the donors and their coregistered recipients underwent surgery simultaneously. In the other five cases, "bridge donors" continued the chain as many as 5 months after the coregistered recipients in their own pairs had received transplants. This report of a chain of paired kidney donations, in which the transplantations were not necessarily performed simultaneously, illustrates the potential of this strategy.