Asynchronous, out-of-sequence, transcontinental chain kidney transplantation: a novel concept

Area of Science:

• Nephrology
• Transplantation Surgery
• Organ Donation

Background:

• The critical shortage of organ donors significantly limits transplantation for patients on waiting lists.
• Living incompatible donors offer an underutilized resource for increasing the kidney donor pool via transplant exchanges.
• Chain transplantation extends this concept, potentially benefiting a larger number of recipients.

Purpose of the Study:

• To describe the first asynchronous, out-of-sequence transplant chain initiated by a transcontinental altruistic donor kidney shipment.
• To evaluate the feasibility and success of the modified-sequence asynchronous transplant chain (MATCH) protocol.
• To highlight a novel strategy for expanding the donor pool and increasing transplant rates.

Main Methods:

• Initiation of a transplant chain with an altruistic donor kidney transported across the country.
• An asynchronous, out-of-sequence donation model where the altruistic donor's recipient's incompatible donor initiated the next step.
• Coordination across four institutions involving transcontinental organ transport.

Main Results:

• Successful immediate function of the altruistic donor kidney post-transplantation.
• The MATCH protocol enabled eight recipients at four institutions to receive transplants.
• Demonstrated the viability of a complex, asynchronous, and geographically dispersed transplant chain.

Conclusions:

• The modified-sequence asynchronous transplant chain (MATCH) is a promising advancement in addressing the organ donor shortage.
• This innovative approach maximizes the impact of altruistic and incompatible donor pairs.
• Further exploration and implementation of MATCH protocols are warranted to increase transplantation opportunities.