Paired Donor Network Program
Research suggests that for patients with end-stage kidney disease, living kidney transplantation is almost always the best therapeutic option over the long term.
Compared to deceased kidney donation – where the kidney that is transplanted comes from someone who recently died – the typical living kidney is likely to work more quickly after surgery and to last, on average, 50 percent longer. In fact, many experts cite the average lifespan for a deceased kidney graft at eight years but the average lifespan for a living kidney at 12 years.
Some patients who need a kidney transplant have friends or loved ones who truly wish to donate their kidneys. However, these donors may be unable to do so because of immunologic reasons. Such reasons may include blood type incompatibility or a history of prior sensitization in the potential recipient to antigens present in the potential donor.
Historically, transplantation has been able to proceed in these cases only by treating the recipient with more intense immunosuppression in order to make the kidney transplant compatible. However, immunosuppression comes with increased risk – and it can’t be done in all cases.
Within the last several years, the transplantation community has addressed this obstacle by building an infrastructure that allows living kidney exchanges to take place. This infrastructure allows the incompatible donor and recipient groups to be joined with another incompatible group or groups. The result: The living donors donate their kidneys to another incompatible group and, in turn, their chosen potential recipients are transplanted from other living donors, as well.
Jefferson's Kidney Transplant Program recognizes that living kidney exchange is currently the best solution to the problem of incompatibility between willing living kidney donors and their potential recipients when no other living kidney donor options exist. We’ve already partnered with one living kidney exchange program. Additionally, we have investigated all the ethical, reputable living kidney exchange programs available. And we are committed to providing this extremely valuable therapeutic option to our patients.
As the infrastructure for these programs continues to grow, we remain hopeful that a national program will develop that will be managed in a manner similar to the current deceased donor United Network for Organ Sharing (UNOS) management. At present, however, participation in a living kidney exchange program places some additional burden on the potential living kidney donor compared to standard direct living kidney donation. In most cases, these donors must duplicate some of the evaluation process and likely must travel to a different transplant program to have their surgery. Further, there are increased complexities involved because most cases of living kidney exchanges require timing coordination between operating rooms at different transplant centers. The benefit of a living kidney transplant, however, clearly is worth these added difficulties.