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Original Article
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Volume 360:1096-1101 March 12, 2009 Number 11
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A Nonsimultaneous, Extended, Altruistic-Donor Chain
Michael A. Rees, M.D., Ph.D., Jonathan E. Kopke, B.S., Ronald P. Pelletier, M.D., Dorry L. Segev, M.D., Matthew E. Rutter, M.D., Alfredo J. Fabrega, M.D., Jeffrey Rogers, M.D., Oleh G. Pankewycz, M.D., Janet Hiller, M.S.N., Alvin E. Roth, Ph.D., Tuomas Sandholm, Ph.D., M. Utku Ünver, Ph.D., and Robert A. Montgomery, M.D., D.Phil.

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SUMMARY

We report a chain of 10 kidney transplantations, initiated in July 2007 by a single altruistic donor (i.e., a donor without a designated recipient) and coordinated over a period of 8 months by two large paired-donation registries. These transplantations involved six transplantation centers in five states. In the case of five of the transplantations, the donors and their coregistered recipients underwent surgery simultaneously. In the other five cases, "bridge donors" continued the chain as many as 5 months after the coregistered recipients in their own pairs had received transplants. This report of a chain of paired kidney donations, in which the transplantations were not necessarily performed simultaneously, illustrates the potential of this strategy.


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From the Department of Urology, University of Toledo Medical Center, Toledo, OH (M.A.R., M.E.R.); the Alliance for Paired Donation, Maumee, OH (M.A.R., R.P.P., M.E.R., J.R., O.G.P.); the Department of Public Health Sciences, University of Cincinnati, Cincinnati (J.E.K.); the Department of General Surgery, Ohio State University, Columbus (R.P.P.); the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (D.L.S., J.H., R.A.M.); Banner Good Samaritan Transplant Services, Phoenix, AZ (A.J.F.); the Department of General Surgery, Transplantation Services, Wake Forest University Baptist Medical Center, Winston-Salem, NC (J.R.); the Department of Surgery, University at Buffalo, State University of New York, Buffalo (O.G.P.); the Department of Economics, Harvard University, Cambridge, MA, and Harvard Business School, Boston (A.E.R.); the Computer Science Department, Carnegie Mellon University, Pittsburgh (T.S.); and the Department of Economics, Boston College, Chestnut Hill, MA (M.U.Ü.).

Address reprint requests to Dr. Rees at the Department of Urology, University of Toledo Medical Center, Mail Stop 1091, 3000 Arlington Ave., Toledo, OH 43614, or at michael.rees2{at}utoledo.edu.

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