Restoring lives, shaping the future
Kidney Paired Donation Program Frequently Asked Questions
Learn whether participation in the Kidney Paired Donation Program at Duke is right for you. Get answers to important questions about the program.
- What is the Kidney Paired Donation Program?
- What kinds of donor exchanges exist?
- What will happen if I agree to enter the Kidney Paired Donation Program?
- What personal information is needed in order to run the match program?
- How will my personal data be used?
- How will my medical information be kept confidential?
- What are the risks of participating in the Kidney Paired Donation Program?
- What are the risks of participating in a Kidney Paired Donation when the kidney is shipped to the recipient transplant center?
- What are the benefits of participating in a Kidney Paired Donation Program?
- What are your alternatives if I decide not to participate in the Kidney Paired Donation Program?
- What costs or payments are involved?
- Who do I contact if I have questions?
What is the Kidney Paired Donation Program?
The Kidney Paired Donation (KPD) Program is a program that assists donor and recipient pairs who are incompatible or poorly matched to find another donor and recipient pair with whom they can exchange kidneys to enable better matching, allowing a transplant to take place.
All medically eligible donor and recipient pairs are able to participate in the KPD program. Although pairs will usually participate because the donor and recipient are incompatible due to blood type or tissue type, compatible pairs may also participate.
Recipients with compatible donors express an interest in participating in KPD programs
- To find a younger or a six antigen (“perfect”) match donor
- To selflessly aid the incompatible pairs in the KPD pool
What kinds of donor exchanges exist?
- Conventional exchange: This exchange occurs between two donor and recipient pairs who are of blood type A and B.
- Unconventional exchange: This exchange uses positive crossmatch pairs and allows all blood types.
- Domino exchange: This exchange occurs with a non-directed donor initiates a series of chain transplants. The final donor donates to someone waiting on the deceased donor list or becomes the domino donor in the next exchange.
What will happen if I agree to enter the Kidney Paired Donation Program?
Once a living donor and recipient are found to be blood type or tissue type incompatible, their medical data is entered into the KPD database. This database allows a computer matching program to be run and will identify compatible donor and recipient pairs.
The goal of the matching program is to identify as many compatible pairs as possible and to maximize the donation of one kidney from a living donor to allow as many kidney transplants as possible take place.
To find a compatible kidney, the KPD database requires your name, age, blood type, tissue type, and any tissue markers (antigens) that need to be avoided in the donor.
The exchange match program is routinely run every four weeks. The goal with matching pairs in the Kidney Paired Donation Program is to find the best outcome for all the pairs involved.
If a potential exchange pair is identified, the match will be reviewed by the transplant surgeon, physicians, and program staff. If the match is favorable, the donors and recipients will be asked to provide a blood sample for cross matching (mixing of blood between recipient and donor to establish compatibility).
If the crossmatch results indicate that the exchange offers a favorable outcome or match for all participants, all participants will be notified.
Once all participants agree to go forward with the exchange, all donor and recipient medical information will be shared with the participating transplant center. Any further evaluation requested by the surgeon or physician to determine eligibility will be completed.
Once the physicians and surgeons accept the medical eligibility of all the participants, then the transplants can be scheduled. The donation surgeries and transplant are scheduled to occur simultaneously.
Pairs will remain in the database as long as all participants are medically acceptable and are willing to participate.
What personal information is needed in order to run the match program?
For a compatible match to be made, the KPD database requires your:
- Name
- Date of birth
- Blood type
- Genetic tissue typing and any tissue markers (antigens) that need to be avoided in the donor
How will my personal data be used?
The personal data entered into the database will be used to identify potential donor and recipient pairs with whom you could exchange to have the greatest number of patients transplanted.
Your data will be shared with the surgeons, physicians, and the transplant team at the recipients’ transplant centers. Your personal data will be stored indefinitely unless you become medically ineligible or withdraw from the program.
How will my medical information be kept confidential?
Once your immunogenic typing has been completed, the Kidney Paired Donation coordinator will enter your information into the KPD database.
If a potential match is identified, your medical information will be shared with the transplant staff, physicians, and surgeons who would be responsible for your care.
Otherwise, your medical information will remain confidential to the extent required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II). Your medical information will not be shared outside the participating transplant centers without your explicit permission.
We try to make sure that everyone who needs to see your information uses it only for the KPD Program and keeps it confidential, although we cannot guarantee this. Access to the KPD database is password protected. Any paper copies of the database will be stored in a secured location.
What are the risks of participating in the Kidney Paired Donation Program?
There are no direct risks of participating in the KPD program. There is a very small risk of the loss of confidentiality of your medical information if the steps outlined above are unintentionally breached.
As with any transplant and donor surgery, unanticipated events may occur with a paired donation transplant.
An event may occur in the operating room that deems it necessary to stop a donor procedure. In this case, one recipient would not receive a kidney. Also, if it was necessary to stop a recipient surgery, a kidney would be available. This kidney would then be distributed according to United Network for Organ Sharing (UNOS) distribution policies and another recipient on the waiting list would be offered the kidney.
You may decide to withdraw from participating in the program at any point.
What are the risks of participating in a Kidney Paired Donation when the kidney is shipped to the recipient transplant center?
The live donor kidney will be shipped via ground transportation to the closest airport and then to the recipient transplant center by air transportation. Inherent in this form of transportation is the risk of courier delay, flight cancellation, or flight delay.
These delays might extend the cold ischemic time of the kidney. With precise logistical coordination, this risk is small. Furthermore, there is evidence that even several hours of cold ischemic time will not affect the outcome of the transplant.
There is the minimal risk of problems not within the control of the transplant center such as plane crash, terrorist activity, and natural disasters. There is a minimal risk of damage to the kidney during transport which would be discovered at the time of inspection of the kidney at the recipient transplant center.
What are the benefits of participating in a Kidney Paired Donation Program?
There is no guarantee that you will receive any benefit from participating in the program. As a recipient, you may receive the benefit of a compatible live donor kidney transplant by participating in the program. There may also be a benefit to you in finding a younger or better tissue-matched live donor.
If you are the donor, you may gain the emotional benefit from donating to a recipient and, additionally, realizing your intended recipient has received a live donor kidney transplant as a result of your donation.
It is not known if or when you might be identified as part of a possible donor-recipient pair. The more participants in the program, the more likely it is that you will be part of a pair identified for a possible donor-recipient exchange.
The risks and benefits of the donation surgery and the transplant surgery will be discussed with you in detail by the appropriate transplant center if and when you consent to move forward with a kidney paired donation transplant.
If you agree to participate in the Kidney Paired Donation Program, you are not obligated to donate a kidney or receive a kidney through the KPD.
What are my alternatives if I decide not to participate in the Kidney Paired Donation Program?
The alternative is to not participate in the program. If you are a potential recipient, you should discuss the alternatives with your transplant surgeon (such as receiving a deceased donor kidney through the national waiting list maintained by the United Network for Organ Sharing (UNOS) or receiving an incompatible kidney transplant from your intended donor).
If you are a potential donor, your options include not donating a kidney or donating a kidney to a different recipient.
Refusal to participate in the program will result in no penalty or loss of benefits to which you are otherwise entitled.
What costs or payments are involved?
There is no cost to you for participating in the program. There will be no payments or compensation of any kind for participating in the program.
Who do I contact if I have questions?
If you have questions, call the transplant office at 919-613-7777 (option 2) or 800-249-5864 and ask for the Kidney Paired Donation coordinator.
