A Kidney's 29-Hour Journey: How New Technology Is Saving More Donor Organs

A portable kidney preservation system recently enabled the successful transplant of a donor organ that had been declined and traveled over 1,000 miles across two commercial flights. The kidney was recovered in Salt Lake City, Utah, transported to California where it was initially rejected, then flown back to Utah and ultimately transplanted into a waiting patient. This real-world case demonstrates how emerging technology is expanding the window of opportunity for organ donation and potentially increasing the number of kidneys available for transplantation.

What Happens When a Donor Kidney Gets a Second Chance?

The journey of this particular kidney illustrates the complex logistics behind organ transplantation. The organ was recovered by DonorConnect, an organ procurement organization (OPO), and initially transported more than 500 miles to a California transplant center via commercial flight. After 10.5 hours at the California facility, the kidney was declined—meaning the transplant team determined it wasn't suitable for their patient at that moment. Rather than being discarded, the kidney was placed back on a second commercial flight and returned to Utah.

What made this second chance possible was the Paragonix KidneyVault Portable Renal Perfusion System, a device that continuously preserves donor kidneys outside the body. The system provided 25 hours and 15 minutes of continuous perfusion—essentially keeping the organ alive and functioning—contributing to a total cold ischemic time of 29 hours and 17 minutes before transplantation. Cold ischemic time refers to the period when an organ is preserved at cold temperatures without blood flow, and minimizing this time is crucial for transplant success.

Why Does Extended Organ Preservation Matter for Kidney Patients?

Traditionally, donor kidneys have a limited window of viability. The longer an organ sits outside the body, the greater the risk of damage and transplant failure. By extending the time a kidney can remain viable, perfusion technology like KidneyVault opens new possibilities for organ allocation. Kidneys that might have been discarded due to time constraints can now be reallocated to other transplant centers, potentially reaching patients who have been waiting months or years for a transplant.

This case represents more than just a single successful transplant. It demonstrates a shift in how the transplant community thinks about organ allocation and preservation. When a kidney is declined at one center, it no longer has to be lost—it can be transported and offered to another center, expanding access to life-saving transplants across geographic regions.

Supporting Living Kidney Donors: New Policy Changes

Beyond technological advances, policy changes are also reshaping kidney transplantation. Congress recently enacted the Honor Our Living Donors (HOLD) Act on January 3, 2026, legislation designed to improve financial support for people who donate a kidney while living. Living kidney donation—where a healthy person donates one of their two kidneys to a family member, friend, or stranger—is a critical source of transplant organs.

The HOLD Act addresses a significant barrier to living donation by streamlining how donors receive financial assistance. Key improvements include:

• Income-Based Eligibility: The law assesses donor support eligibility based on the donor's income, removing previous financial barriers that prevented some people from donating.
• Simplified Process: The legislation streamlines the process by which living donors can offset costs associated with donating a kidney, such as travel, lost wages, and medical expenses.
• Expanded Access: By removing financial obstacles, the HOLD Act aims to expand access to transplantation for patients waiting for kidneys.

"No American should face out-of-pocket costs for giving the gift of life as a living kidney donor," said Prabir Roy-Chaudhury, MD, PhD, FASN, president of the American Society of Nephrology (ASN). "The HOLD Act advances that goal by simplifying the process by which living donors can offset the costs associated with donating a kidney".

Recognition for Advancing Dialysis and Transplant Care

The field of nephrology—the medical specialty focused on kidney health—continues to evolve through the work of dedicated researchers and clinicians. Ron Wald, MDCM, MPH, medical director of hemodialysis at St. Michael's Hospital in Toronto, Canada, will receive the J. Michael Lazarus Distinguished Award at the National Kidney Foundation 2026 Spring Clinical Meetings in May. This award honors nephrologists whose work advances dialysis care and renal replacement therapy research.

Dr. Wald's research spans critical care nephrology and maintenance dialysis, including leadership in international trials such as STARRT-AKI, Probe-Fluid, WISDOM, and PHOSPHATE, shaping patient care worldwide. "By bridging clinical science with compassionate care, Dr. Wald has made a lasting impact on how dialysis patients are treated and supported," said Kirk Campbell, MD, president of the National Kidney Foundation.

Empowering Patients Through Local Advocacy

Beyond medical advances and policy changes, patient advocacy is playing an increasingly important role in kidney health. The American Kidney Fund (AKF) has unveiled a new advocacy resource called "2026 Kidney Policy: Take Action Where You Live!" This interactive tool provides a state-specific view of active legislation related to kidney health, allowing users to learn about key kidney-related policy priorities in every state and identify ways to engage with policymakers.

The map-based resource helps patients, families, and advocates stay informed about local kidney policy issues, connect with tailored advocacy opportunities, and share information with their communities. By empowering individuals to engage in the policy process, the AKF is working to improve access to care, coverage, and treatment options for the millions of Americans living with kidney disease.

Together, these developments—advanced preservation technology, supportive legislation for living donors, recognition of clinical excellence, and grassroots advocacy tools—represent a multifaceted approach to improving kidney health outcomes and expanding access to life-saving transplants.