Why are kidney transplants from living relatives often more successful than transplants from deceased donors?

Kidney transplants from living relatives are often more successful than those from deceased donors primarily because they are less likely to be rejected by the recipient's immune system.1

The success of a transplant depends heavily on tissue typing, which identifies human leukocyte antigens (HLA) to determine how closely a donor's profile matches the recipient's. Because related donors share genetic material, the likelihood of a compatible match is significantly higher than with unrelated cadaver donors.12

Additionally, logistical factors contribute to better outcomes. When a kidney is taken from a living donor, the surgery is coordinated so that the organ is transplanted immediately, minimizing the time it is deprived of a blood supply. In contrast, kidneys from deceased donors must be preserved and transported, which can lead to a gradual deterioration of the organ. Consequently, while cadaver kidneys may take up to two weeks to adjust and become functional, kidneys from living donors often begin to function immediately.31