Guidelines for uncommon forms of living donation, such as multiple donations from the same person, are lacking. To inform future practice standards, we examined the national US landscape of living donors of more than one solid organ.

METHODS: We used SRTR to identify 100 individuals who donated multiple solid organs either during the same operation (N=52) or separate operations (N=48). Differences between second-operation donors and first-operation donors were compared with rank-sum or chi-squared tests.

RESULTS: Among 48 patients with separate operations, 21 people donated a kidney followed by a liver segment, 15 donated liver-then-kidney, 4 donated lung-then-kidney, 3 donated liver-then-intestine, 3 donated kidney-then-pancreas, 1 donated lung-then-liver, and 1 donated pancreas-then-kidney. 18 of the 48 donors who underwent two separate operations (38%) donated the 2 organs to the same recipient. Median (IQR) time between donations was 3.7 (1.8-6.1) yrs. Second-operation kidney donors were not different from first-operation kidney donors in age, sex, race, or ethnicity (all p > 0.05). Second-operation liver donors were older (p=0.01) than first-operation liver donors but were not different in sex, race, or ethnicity (all p > 0.05).

Among the 52 patients with a two-organ donation operation, 48 donated kidney/pancreas and 4 donated liver/intestine. Each donor donated both organs to the same recipient. Simultaneous donations occurred at only 2 centers. CONCLUSIONS: Living donation of multiple solid organs from the same person is an under-recognized and under-studied practice. Recognition and careful monitoring of the outcomes after multiple donations is needed to inform clinically and ethically appropriate policies for selection, informed consent, and post-donation care for this community of living donors.

CITATION INFORMATION: Thomas A, Massie A, Garonzik-Wang J, Lentine K, Henderson M, Segev D. Landscape of Multiple Donations from a Living Donor in the US. Am J Transplant. 2017;17 (suppl 3).

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