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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

606
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

592
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
592

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Related Experiment Video

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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
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Expedited Transplant Allocation Using a Paired Kidney Cohort.

Miko E Yu1,2, S Ali Husain1,2, Emma G Tucker1,2

  • 1Vagelos College of Physicians & Surgeons, Columbia University, New York, New York.

JAMA Network Open
|March 4, 2026
PubMed
Summary
This summary is machine-generated.

Organ procurement organizations are increasingly using expedited (out-of-sequence) kidney transplants to maximize organ utility. This study found that these transplants have similar patient and graft survival rates compared to standard in-sequence transplants.

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Area of Science:

  • Nephrology
  • Transplant Surgery
  • Public Health Policy

Background:

  • Organ procurement organizations (OPOs) are increasingly utilizing expedited (out-of-sequence) deceased donor kidney allocations.
  • This practice aims to maximize the utility of kidneys at risk of nonuse.
  • Understanding the outcomes of these expedited transplants is crucial for optimizing organ allocation systems.

Purpose of the Study:

  • To identify and compare kidney pairs from the same donor where one kidney was transplanted in sequence and the other out of sequence.
  • To evaluate the incidence and survival outcomes of unilateral out-of-sequence kidney transplants.

Main Methods:

  • Retrospective cohort study utilizing US kidney transplant registry data from the Scientific Registry of Transplant Recipients (SRTR).
  • Analysis included deceased donors from 2020-2024 with at least one kidney transplanted out of sequence.
  • Comparison of recipient demographics and survival outcomes between unilateral in-sequence and out-of-sequence kidney transplants.

Main Results:

  • A total of 15,602 kidneys from 8,544 deceased donors were analyzed, with 50.5% having a unilateral out-of-sequence kidney.
  • Recipients of unilateral out-of-sequence kidneys were more likely to be older, Asian, White, male, have private insurance, and receive preemptive transplants (all P < .001).
  • Adjusted Cox models showed no significant difference in patient survival (HR, 0.84; P = .08) or graft survival (HR, 0.87; P = .20) for unilateral out-of-sequence transplants compared to in-sequence transplants.

Conclusions:

  • Unilateral out-of-sequence kidney transplants have become more common, increasing from 97 instances in 2020 to 1,698 in 2024 across all US OPOs.
  • The study highlights the importance of understanding donor and allocation factors driving these expedited transplants.
  • These findings are critical for designing future organ allocation systems to improve organ use rates while maintaining patient outcomes.