Does shipping a kidney from a live donor hurt the chances of a successful transplant?

Former StaffTransplant News

You’ve watched it unfold on television or the big screen. A doctor, racing against time, removes a kidney and places it into a cooler, and an assistant runs it to a waiting helicopter. It’s flown to another hospital, and is placed into the waiting patient with seconds to spare.

In real life, kidneys are often shipped many miles to complete a kidney paired donation (KPD), where a patient who needs a new kidney is matched with a living donor who may live across the country. It’s important to know whether the shipping process is damaging to the kidney or affects the success of the transplant.

Drs. Jeffrey Veale and Amy Waterman of the University of California, Los Angeles (UCLA) looked at a group of patients that had received kidneys through KPD facilitated by the National Kidney Registry (NKR), and compared those patients to a nationwide group of unrelated living donor kidney transplants that were not shipped or part of a KPD.1

One problem with shipping kidneys is the amount of time the kidney is on ice, after it’s taken from the donor and before it’s placed into the recipient. This study found that longer times outside the body were not associated with the transplant failing more often, or more patients dying. They also found that these results were the same in a patient over the age of 50 as in a younger patient.

Some countries, such as Canada and the Netherlands, never ship living donor kidneys, but in the United States, the NKR has been routinely shipping kidneys since 2008. Dr. Waterman said, “In situations where a living donor kidney is flown from a transplant center in Los Angeles to New York, we now can predict that this shipped kidney should last the same amount of time and work as well as a kidney donated and transplanted in California.”

Research like this can lead to a better understanding of how far a kidney can be safely shipped from a living donor to a waiting recipient. This can create more matches, and save more lives.

1. Treat E, Chow EKH, Peipert JD, Waterman A, Kwan L, Massie AB, Thomas AG, Bowring MG, Leeser D, Flechner S, Melcher ML, Kapur S, Segev DL, Veale J. Shipping Living Donor Kidneys and Transplant Recipient Outcomes. Am J Transplant. 2018 Mar;18(3):632-641. doi: 10.1111/ajt.14597. Epub 2017 Dec 18.