title: Utilization of Deceased Donor Kidneys to Initiate Living Donor Chains.
abstract: We propose that some deceased donor (DD) kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor (LD) kidney transplants to address, in part, the huge disparity between patients on the DD kidney waitlist and available donors. The use of DD kidneys for this purpose would benefit waitlisted candidates in that most patients enrolled in kidney paired donation (KPD) systems are also waitlisted for a DD kidney transplant, and receiving a kidney through the mechanism of KPD will decrease pressure on the DD pool. In addition, a LD kidney usually provides survival potential equal or superior to that of DD kidneys. If KPD chains that are initiated by a DD can end in a donation of an LD kidney to a candidate on the DD waitlist, the quality of the kidney allocated to a waitlisted patient is likely to be improved. We hypothesize that a pilot program would show a positive impact on patients of all ethnicities and blood types.
authors.affiliation: Surgery, Stanford University, Palo Alto, CA.
authors.forename: M L
authors.initials: ML
authors.lastname: Melcher
authors.affiliation: Surgery, University of California at San Francisco, San Francisco, CA.
authors.forename: J P
authors.initials: JP
authors.lastname: Roberts
authors.affiliation: Arbor Research Collaborative for Health, Ann Arbor, MI.
authors.forename: A B
authors.initials: AB
authors.lastname: Leichtman
authors.affiliation: Economics, Stanford University, Stanford, CA.
authors.forename: A E
authors.initials: AE
authors.lastname: Roth
authors.affiliation: Urology, University of Toledo Medical Center, Toledo, OH.|Alliance for Paired Donation, Perrysburg, OH.
authors.forename: M A
authors.initials: MA
authors.lastname: Rees
mesh_terms: D001787:Blood Group Incompatibility; D046148:Donor Selection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*; D014850:Waiting Lists
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