What is a Kidney Donation Chain?

A paired kidney exchange (or "kidney swap") occurs when a living kidney donor is incompatible with the recipient, and so exchanges kidneys with another donor/recipient pair. Two live donor transplants would occur.

The best treatment option for someone with kidney failure is a living kidney transplant.   Kidney transplants from a living donor function an average of 20 years compared to 10 years from a deceased donor.  Currently, in San Diego, the waiting time for a deceased donor is 8 to 10 years.  During this time, the recipient can become ill and not qualify for a kidney transplant.

The first step in living donation is to determine if the donor and recipient are compatible.    If the donor is compatible, they can directly donate to the recipient.   Our body’s immune system is responsible for protecting us again infection, virus, cancer and foreign tissues.  This can cause a donor not to match with the recipient. 

If they are not compatible, the living kidney donor can donate through a kidney paired exchange program (KPE).  The donor will donate to a recipient that they are compatible with and the recipient is matched with a donor that is compatible with them.  This is an example of a two- way chain or swap.

It can also start with a Good Samaritan donor who wants to donate to help someone but does not have a recipient to donate directly too. This is also known as a non-directed donor. (NDD).

In order to be a living kidney donor, an individual must be in overall good health, and over the age of 18 and under the age of 80. Certain medical conditions will result in a potential living donor being considered ineligible for donation, such as kidney or heart disease, uncontrolled high blood pressure, diabetes, cancer (within the last five years), and current major infections, such as HIV, Hepatitis B or Hepatitis C.

This incredible story about two brothers here in San Diego may help you have a better understanding of Living Kidney Paired Exchange Donation.

Special thanks to Sharp Kidney Transplant Coordinator, Tammy Wright for sharing her article!

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