The Fast-Track Program: A new Organizational Model to Enhance Living Donor and Pre-emptive Kidney Transplantation

Living donor kidney transplantation (LD KTx), especially when performed pre-emptively, remains the gold standard for treating end-stage renal disease (ESRD). In Italy, however, this resource remains underutilized due to significant organizational hurdles and protracted evaluation timelines. To overcome this limitation, a Fast-track program (FTp) was developed in our Center, aiming to perform the clinical work-up of donor and recipient candidates pairs (DR) in five consecutive days with dedicated schedules on outpatient basis. The results so far obtained in twenty DR evaluated with the FTp indicate an important reduction in the time between the first consultation and LD KTx and a higher proportion of pre-emptive KTx compared to fifty-four DR studied with the traditional work-up protocol (Tp). By simplifying logistics for patients traveling from distant regions, this model could serve as a scalable template to improve transplant access and outcomes at both regional and inter-regional levels.