Report from the National Kidney Registry

The American Journal of Transplantation has published (early, online) a report detailing some of the successes of the National Kidney Registry with long, non-simultaneous chains:

Chain Transplantation: Initial Experience of a Large Multicenter Program, by
M. L. Melcher, D. B. Leeser, H. A. Gritsch, J. Milner, S. Kapur, S. Busque, J. P. Roberts, S. Katznelsonf, W. Bry, H. Yang, A. Lu, S. Mulgaonkar, G. M. Danovitch, G. Hil, and J. L. Veale.


"The first 54 chains facilitated 272 transplantations between February 14, 2008 and June 29, 2011.
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"These first 272 transplants were completed in 40 months and were part of 54 chains that averaged 5.0 transplants long.
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"In the NKR experience many bridge donors remained motivated and donated months after their intended recipients’ transplantation. One bridge donor even donated more than 1-year afterwards.
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"The longest chain involved 21 recipients and 21 donors.
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"There were seven broken chains due to bridge donors becoming unavailable. Unlike traditional paired donation where the consequences of a donor ‘backing-out’ are devastating, in chain transplantation, the next recipient does not suffer ‘irreparable harm’ as they have not lost their willing incompatible donor and can participate in a new exchange when the transplants are carried out sequentially."