{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:42:21Z","timestamp":1771922541090,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Living donor kidney transplantation (LDKT) provides superior outcomes for patients with end-stage kidney disease (ESKD) but remains underutilized due to persistent barriers including donor-recipient incompatibility, financial concerns, and limited donor outreach. This study describes a center-based strategy implemented at Penn Medicine\u2019s Center for Living Donation to specifically address these challenges and expand access to LDKT. Key components included the development of a dedicated infrastructure for donor evaluation, the integration of Living Donor Navigators to guide and support donors, and the use of personalized microsites through the National Kidney Registry (NKR) to facilitate recipient-driven outreach. Financial barriers were reduced through accessing national assistance programs, while participation in kidney paired donation and the NKR Voucher Program enabled flexibility in overcoming immunologic and timing obstacles. This coordinated approach resulted in a substantial increase in living donor transplants, including more than 100 KPD transplants in a single year\u2014a global record. Donor and recipient satisfaction was consistently high, underscoring the effectiveness of the center\u2019s patient-centered model. These findings demonstrate the impact of structured and scalable interventions designed to enhance access to LDKT. The Penn model offers a practical framework for other transplant centers seeking to reduce barriers and expand living kidney donation.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1700930","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:27:36Z","timestamp":1768886856000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transplant center practices that maximize access to living kidney transplantation: the Penn experience"],"prefix":"10.3389","volume":"16","author":[{"given":"Emre","family":"Arpali","sequence":"first","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin","place":["Milwaukee, WI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Abu-Gazala","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital of the University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Robert R.","family":"Redfield","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Irvine","place":["Irvine, CA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Leonberg-Yoo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital of the University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ty B.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin","place":["Milwaukee, WI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15315","article-title":"Expanding the access to kidney transplantation: Strategies for kidney transplant programs","volume":"38","author":"Nishio Lucar","year":"2024","journal-title":"Clin Transpl"},{"key":"B2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/TP.0000000000005197","article-title":"Supporting financial neutrality in donation of organs, cells, and tissues","volume":"109","author":"Martin","year":"2025","journal-title":"Transplantation"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14840","article-title":"Kidney paired donation-european transnational experience in adults and opportunities for pediatric kidney transplantation","volume":"28","author":"Bohmig","year":"2024","journal-title":"Pediatr Transpl"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005029","article-title":"Kidney paired donation in Latin America and the Caribbean: an update","volume":"108","author":"Bastos","year":"2024","journal-title":"Transplantation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/TP.0000000000005124","article-title":"Expanding opportunities for living donation: recommendations from the 2023 Santander summit to ensure donor protections, informed decision making, and equitable access","volume":"109","author":"Lentine","year":"2025","journal-title":"Transplantation"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/eurjcn\/zvae012","article-title":"Patient journey mapping: emerging methods for understanding and improving patient experiences of health systems and services","volume":"23","author":"Bulto","year":"2024","journal-title":"Eur J Cardiovasc Nurs"},{"key":"B7","article-title":"Penn Medicine sets a worldwide record with 100 kidney paired donation transplants in a year","author":"Toal","year":""},{"key":"B8","unstructured":"Microsites: Tools to find a living donor"},{"key":"B9","unstructured":"Donor shield"},{"key":"B10","unstructured":"National living donor assistance center > resources > FAQs"},{"key":"B11","unstructured":"Voucher program"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16396","article-title":"Expanding living donor liver transplantation: Report of first US living donor liver transplant chain","volume":"21","author":"Braun","year":"2021","journal-title":"Am J Transpl"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15386","article-title":"Bi-organ paired exchange-Sentinel case of a liver-kidney swap","volume":"19","author":"Torres","year":"2019","journal-title":"Am J Transpl"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1700930\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:37:24Z","timestamp":1771918644000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1700930\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":13,"alternative-id":["10.3389\/fimmu.2025.1700930"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1700930","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"article-number":"1700930"}}