Center Petitioning of the US Department of State Increases Access to Living Kidney Donation for Legal Immigrants and Naturalized Citizens on the Transplant Waiting List

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

11-1-2021

DOI

10.1016/j.jamcollsurg.2021.08.536

Journal Title

Journal of the American College of Surgeons

Department

Surgery

Abstract

Introduction

Live donor transplantation (LD) affords shorter wait time and better outcomes. For legal immigrants or naturalized citizens in the USA, LD candidates may exist in their country of origin but are not considered because of immigration restrictions. We evaluated the impact of targeted petitioning of the US Department of State (DOS) on access to potential foreign national (FN) LD candidates.

Methods

This is a single center retrospective study. Letters were sent on behalf of 24 pre-screened (blood type, renal function, sonography) FN LD to the DOS in six countries between 2011 and 2019. The FN LD and recipient outcomes were compared to 25 US resident donors (ND).

Results

DOS approved 21 (86%) and denied three candidates. Fourteen (70%) became donors. Seven were declined (5 for disease, one positive cross match and one withdrew). Declined candidates and LDs returned to their homelands. DOS approved one for residency. FN compliance with UNOS clinical and laboratory required LD data reporting were 90 % vs. 80% (ND) and 85% vs. 70%, respectively. There were no significant differences in recipients’ average wait times (251 days [FN] vs. 153 days [ND]). FN recipient graft and patient survival at one year and three years were 92.86% and 86.22%, while they were 96.43% and 96.43 for ND recipients (ns).

Conclusion

Center specific petitioning of DOS can provide access to LD transplants for legal immigrants and naturalized citizens within the US. FN donors were compliant with data reporting requirements and recipient outcomes were similar and acceptable.

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