The Nondirected Living Donor Program: A Model for Cooperative Donation, Recovery and Allocation of Living Donor Kidneys

We describe an altruistic nondirected (ND) and live donor/deceased donor list exchange (LE) donor program administered by an organ procurement organization (OPO) in the Washington, DC area. Screening eliminated 25 donors (17 NE; 8 LE) from the 97 donor applications (62 ND; 35 LE) completed. Twenty‐one donors (16 ND; 5 LE) failed to follow through with the psychiatric evaluation, which eliminated 13 donors (9 ND; 4 LE). Two donors dropped out and 12 (9 ND; 3 LE) were medically unsuitable after final clinical evaluation. Twenty donor procedures were performed (10 ND; 10 LE) with four pending (2 ND; 2 LE). This resulted in a modest 3–5% increase in the OPO‐procured kidney organ pool. The average cold ischemia time of the grafts not transported between transplant centers was 205 ± 66 min compared with 243 ± 48 min for transported grafts. With no documented adverse outcomes, donors had a hospital stay of length 2.9 days and at home recuperation of 12.3 days. Three‐ and 6‐month creatinines were 1.44 ± 1.36 and 1.68 ± 0.61 for grafts not transported between transplant centers, and 1.6 ± 0.27 and 1.6 ± 0.44 for transported grafts. An OPO‐administered altruistic donor program can serve as a model for cooperative donation, recovery and allocation of living donor kidneys.

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