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printer-friendlyDr. Arthur Matas, one of our transplant surgeons, has been head of the kidney transplant program at the University of Minnesota for many years and now directs our Living Donor Program. He leads the team of authors posting to our blog. That team includes Cheryl Jacobs, Dawn Larson, Margaret Voges and Cathy Garvey, who work with our donors every day.
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Paired Exchange Program
Finding a friend or relative to donate a kidney is a great option. Yet, sometimes the potential donor is not compatible with the recipient. There must be a blood type and tissue "match" between the donor and the recipient before we can do the transplant.*
If a recipient and the potential donor are not a match, "paired exchange" is another option. This is how it works:
You and your incompatible donor are entered into a database. The software looks for matches. If there is a match, you would be matched to a donor who is also incompatible with their recipient. That person's recipient would then receive a kidney from your donor in a basic swap, or a chain reaction. A chain reaction is when there are multiple matches among a group of people. Many of the paired exchange lists around the country have had successful large chains of pairs.
At the University of Minnesota Transplant Center we are participating in three exchange lists:
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North Central Donor Exchange Cooperative which is based in the upper midwest. There are 9 transplant centers in this consortium. The website is www.ncdec.org.
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Alliance for Paired Donation (APD) is based at University of Toledo, Ohio. It started in 2007. Currently there are 69 transplant centers from across the country that are registering pairs for matching in this database. This exchange has been using non-directed donors to optimize the number of transplant possibilities. A non-directed donor is someone who wants to donate a kidney to anyone who needs it. A non-directed donor's involvement can allow a long chain of transplants to occur, spread out over a period of months. For example, a non-directed donor gives a kidney to a recipient in the database. That recipient's "mismatched" donor then agrees to give a kidney to someone else, as soon as a match becomes available. In this way, several donations can take place in a chain over time. There has been a successful chain of as many as 10 transplants. You can learn more about paired exchange at www.paireddonation.org.
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National Kidney Registry is based in New York. There are 30 transplant centers from across the U.S that are registered with this network. They have done 61 transplants to date. Their website is www.kidneyregistry.org.
The Paired Exchange Program consists of:
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We will determine whether you and your donor are a compatible match.
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We will do a full medical and psychosocial evaluation to determine if you are approved paired exchange candidates.
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We will then list you and your donor in a paired exchange database, including how far the donor is willing to travel to donate a kidney. A blood sample may be required for crossmatching purposes.
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If a match occurs, we will share both the donor and recipient records with the other participating transplant center(s) and tissue compatibility will be confirmed.
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All of the transplant centers involved will negotiate a date if a simultaneous transplant is needed. The donor may have surgery at the donor's center or at the recipient's center, depending on donor wishes and other logistics pertaining to the individual situation. If the donor's surgery is not in the same location as the recipient's surgery, a special transport vehicle will take the kidney from one site to the other. If the donor travels, expenses for travel are not paid for by insurance - see our Financial Considerations post.
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The donor and recipient will need a checkup two weeks after surgery at either our Transplant Center or at the recipient surgery site.
*ABO blood type mismatch
Posted: 11/24/2009 11:14 a.m. by Margaret Voges, R.N., B.A.N.
