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The History of Shipping Live Donor Kidneys … Taking the leap of faith

The History of Shipping Live Donor Kidneys … Taking the leap of faith. Jeffrey L. Veale, MD Director, UCLA Kidney Transplant Exchange Program. Shipping Live Donor Kidneys - Now. National Kidney Registry (NKR) has facilitated 941 Exchanges, approx 600 have been shipped. Jason. Jason ’ s

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The History of Shipping Live Donor Kidneys … Taking the leap of faith

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  1. The History of Shipping Live Donor Kidneys…Taking the leap of faith Jeffrey L. Veale, MD Director, UCLA Kidney Transplant Exchange Program

  2. Shipping Live Donor Kidneys - Now National Kidney Registry (NKR) has facilitated 941 Exchanges, approx 600 have been shipped

  3. Jason Jason’s Mom Tiffany Tiffany’s Dad Donation Donation Shipping Live Donor Kidneys - 2007 • Exchange donors were reluctant to travel to another center: • -unfamiliar hospital • -unfamiliar city • -away from the intended recipient • -away from family David Geffen School of Medicine at UCLA

  4. Shipping Live Donor Kidneys - 2007 Simpkins et al. Reviewed 38,467 living donor transplants 32,719 (85%) had CIT less than 2 hours 393 (1%) had CIT of 6-8 hours No statistically significant difference in 1-year creatinine level or the 10-year allograft survival between the groups

  5. Taking the leap of faith 2007 Montgomery performed first live donor kidney shipped “coast-to-coast” San Francisco to Baltimore Private Jet (accompanied by the surgeon) GPS Tracking Device with the kidney 8 hours of CIT cost = $27,000 2008 Veale performed second live donor kidney shipped “coast-to-coast” New York to Los Angeles Commercial Airline (unaccompanied) No Tracking Device 14 hours of CIT cost = $550 *Saved tens of thousands of dollars (compared to private jet or desensitization)

  6. Taking the leap of faith

  7. Transporting live donor kidneysUCLA UCLA unpublished data: -57 shipped live donor kidneys -Mean CIT 12.1h -Longest CIT approx 19h -70yo shipped kidney donor (13h CIT) When compared to a non-shipped live donor cohort (matched for gender, age and center): -No significant differences in creatinine at every time interval measured up to 2 years -70yo shipped kidney, the cr of recipient is 1.4 Segev, Veale et al. 56 live donor kidneys transported between 30 U.S. centers Mean CIT was 7hrs with no DGF David Geffen School of Medicine at UCLA

  8. International Exchanges 2011 Sep 1;365(9):868-9 Kidney paired donation –the next step. Connolly JS, Terasaki PI, Veale JL.

  9. Terasaki and Collins 44 years ago 1970 Terasaki reported - Shipped live donor mammalian kidneys Dog kidneys LA to London LA to Sydney LA to Tel Aviv A few with nearly 50 hrs of CIT Functioned 44 yrs ago shipped live donor kidneys “Just Saying”… “Make the leap of faith”

  10. The History of Shipping Live Donor Kidneys…Taking the leap of faith Jeffrey L. Veale, MD Director, UCLA Kidney Transplant Exchange Program

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