Sequential Donation: Evaluating Safety and Quality of Life of Living Donors

One of the most persistent problems in transplantation in the U.S. is the demand for organs outweighs the supply. Sequential living donation may be one strategy to address this problem, however a reluctance to perform these surgeries exists secondary to the lack of research on the medical outcomes and quality of life of sequential post-donation. A medical record review of 34 sequential liver and kidney living donors and matched controls (by sex, age within 7 years, timing of surgery, and last organ donated) was performed. No significant difference between groups were observed on sociodemographic characteristics with the exception of age [p = 0.030] and marital status [p = 0.010] whereas matched controls were older and more likely to be married. One sequential donor started a chain for both organs which resulted in 7 transplant candidates receiving an organ. No statistically significant differences were observed in the number of complications [p = 0.081], emergency room visits [p = 0.573], 30-day [p = 0.573], 90-day readmissions [p < 0.999], or physical [p = 0.09] or mental health domains of quality of life [p = 0.78] at six or more months post-donation. Sequential donors returned to tobacco use more often than controls [p = 0.03] and matched controls were more likely to gain weight [p = 0.02] post donation. While further research is warranted, this study provides early evidence of the short-term safety of sequential donation.