title: The nondirected living donor program: a model for cooperative donation, recovery and allocation of living donor kidneys.
abstract: 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.
authors.affiliation: Department of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA. gilbertj@cnmc.org
authors.forename: James C
authors.initials: JC
authors.lastname: Gilbert
authors.forename: Lori
authors.initials: L
authors.lastname: Brigham
authors.forename: D Scott
authors.initials: DS
authors.lastname: Batty
authors.forename: Robert M
authors.initials: RM
authors.lastname: Veatch
mesh_terms: D000328:Adult; D001675:Bioethics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia; D016030:Kidney Transplantation / Q000941:ethics / Q000379:methods*; D019520:Living Donors / Q000941:ethics / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods