M L Melcher, J P Roberts, A B Leichtman, A E Roth, M A Rees

We propose that some deceased donor kidneys be allocated to initiate non-simultaneous extended altruistic donor chains of living donor kidney transplants to address in part the huge disparity between patients on the deceased donor kidney waitlist and available donors. The use of deceased donor kidneys for this purpose would benefit waitlisted candidates in that most patients enrolled in kidney paired donation systems are also waitlisted for a deceased donor kidney transplant and receiving a kidney through the mechanism of kidney paired donation will decrease pressure on the deceased donor pool. In addition, a living donor kidney usually provides survival potential equal or superior to that of deceased donor kidneys. If kidney paired donation chains that are initiated by a deceased donor can end in a donation of a living donor kidney to a candidate on the deceased donor waitlist, the quality of the kidney allocated to 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. This article is protected by copyright. All rights reserved.