Reuse of a living donor kidney: A case study

Reuse of a previously transplanted solid organ for another recipient prevents waste of functioning organs. Here, we present a case of a kidney transplant in which the donor had previously received a kidney from a living donor 6 years earlier. We discuss system inefficiencies and gaps that complicate clinical decision making in this context. For example, during allocation donor ID, KDPI and HLA typing misrepresent the kidney that is from a prior donor potentially confounding virtual crossmatching. In addition, samples of PBMC received from the donor are insufficient for physical crossmatching. As well, peri-operative and post-transplant management in this context requires assessment of donor specific antibodies to the current and prior donor.