The landscape of international living kidney donation in the United States

Abstract

The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government. The data reported here have been supplied by the Minneapolis Medical Research Foundation (MMRF) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the U.S. Government. Supporting Information Additional material may be found online in the Supporting Information section for this article.

Evaluation and care of international living kidney donor candidates: Strategies for addressing common considerations and challenges

“…From a program perspective, it is worth noting that OPTN policy‐compliant donor follow‐up was substantially lower for international living donors at 6, 12, and 24 months postdonation (2015 cohort: 45%, 33%, and 36% compared to 76%, 71%, and 70% for domestic living kidney donors, P < .001) . Transplant programs, especially small‐volume programs, should be aware of the possible adverse impact of accepting international donors on the program's follow‐up performance metrics…”

“…Approximately 100‐150 LDKT from persons who are neither US citizens nor US residents (“international donors”) are performed in the United States each year . In 2015‐2016, the most frequent countries of origin for persons serving as international kidney donors in the United States were Mexico (N = 55), Kuwait (N = 22), Canada (N = 16), India (N = 16), Qatar (N = 15), the Dominican Republic (N = 14), the Philippines (N = 11), and the United Arab Emirates (N = 10); 63 other countries were represented, including 29 countries with a single donor each . Generally, international donors are family members or friends of patients with ESKD who visit the United States to serve as living kidney donors.…”

“…Whereas some countries prohibit international donors due to concerns for organ trafficking or transplant commercialism, the United States has no such prohibition . A recent study of US Organ Procurement and Transplantation Network (OPTN) registry data found that international living kidney donors were tightly clustered among a small number of transplant centers . Resources for helping transplant programs understand and address challenges to assessment and care of international donor candidates may improve consideration of international donors for US kidney patients, but to date, the nature of these challenges, and strategies to address them, has not been well described.…”

“…9 Among Asian versus white candidates, LDKT was 44% less likely in 1995-1999 and 58% less likely in 2010-2014. 9 In 2014, 11 Generally, international donors are family members or friends of patients with ESKD who visit the United States to serve as living kidney donors. Whereas some countries prohibit international donors due to concerns for organ trafficking or transplant commercialism, the United States has no such prohibition.…”

Care of international living kidney donor candidates in the United States: A survey of contemporary experience, practice, and challenges

“…12,13 A recent study of US Organ Procurement and Transplantation Network (OPTN) registry data reported that international living kidney donors (ILKDs) were predominantly performed by a small number of transplant centers. 9 Better understanding of the challenges faced in assessment and care of ILKD candidates and donors may improve consideration of ILKD for US kidney patients, but to date, the nature of these challenges, and strategies to address them, have not been well described.…”