Background: A primary obstacle to providing renal transplantation is limited access to donated kidneys. The living donor pool for renal allografts was greatly expanded through implementation of a kidney paired donation program. While some programs ship donor kidneys, others send living donors to the site of renal transplantation. Performing the nephrectomy and transplant at the same location may optimize functional renal outcomes, but preferred surgical approaches may differ between surgical teams performing the donor work-up and donor surgery. Our objective was to identify incongruence between the surgery planned by the team that performed each donor's work-up, and the surgery that took place at the site of donation.

Methods: A retrospective chart review was performed between the site of pre-operative surgical planning and the site of surgery for kidney donors in the Canadian kidney paired donation program.

Results: We obtained charts for 51 donors that were pre-operatively worked-up in various Canadian provinces between 2009 – 2016, and subsequently underwent surgery in a different province. The surgical procedure performed for 31% of the patients' nephrectomies differed from the procedure suggested by the surgical team who conducted the pre-operative work-up. Half of these differences were between left laparoscopic and left laparoscopic hand assisted, but the remainder included more substantial changes of side and/or laparoscopic versus open procedures.

Conclusion: Optimal patient care is challenged in a kidney paired donation program that utilizes the 'traveling donor' approach, due to differing surgical techniques selected by the surgeon at the site of donor work-up, and the surgeon at the site of donation.

CITATION INFORMATION: Reikie B, Kroczak T, McGregor T. Challenges for the Travelling Donor: Variability Between Donor Work-Up and Donor Surgery in the Canadian Kidney Paired Donation Program. Am J Transplant. 2017;17 (suppl 3).

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