The Duke Kidney Paired Donation Program assists donor and recipient pairs who are incompatible or poorly matched in finding another donor and recipient pair with whom they can exchange kidneys to enable better matching, allowing a transplant to take place.

Participation in Kidney Paired Donation Program

All recipient and donor pairs are eligible to be evaluated for the Kidney Paired Donation Program (KPD). Pairs most often enter the KPD program because of:

• Blood type incompatibility
• HLA incompatibility
• Voluntary kidney paired donation (VKPD)

Pairs who enter the program desire a donor who is better matched immunologically or chronologically. Pairs may also be interested in entering the KPD out of altruism -- their participation would allow more patients to be transplanted.

It has been estimated that if compatible pairs entered the pool it would increase the number of transplants by 1,000 or more per year. Additionally, 45 percent of the compatible pairs could find a six antigen match or younger donor by entering the KPD program. This would translate into an increased chance of the transplant kidney working better for longer.

Benefits of Kidney Paired Donation

Since the Kidney Paired Donation Program began, many benefits have been identified, including:

• Patients receive a living donor kidney with better long-term graft survival than with deceased donor kidney.
• Patients with blood type or tissue type incompatibilities can be transplanted with compatible donors without costly desensitization procedures.
• Patients with an extremely high level of isoagglutinin or human leukocyte antigen (HLA) antibodies can receive a kidney with a more favorable incompatibility profile, making desensitization procedures more successful.
• Recipients avoid prolonged waiting times for a deceased donor organ.
• Living donors may receive an emotional benefit knowing that they are able to fulfill their desire to help a loved one and perhaps a number of recipients.
• Patients removed from the deceased donor list by KPD allow more deceased donor organs to be available to those without living donors.
• Non-directed donors receive satisfaction from knowing their donation has helped more than one person receive a kidney.

Risks of Kidney Paired Donation

As with any innovative program, certain risks exist. In the Kidney Paired Donation Program, the risks include:

• Surgical risks associated with transplant and donation surgery
• Long-term medical risks to living donor, including, but not limited to chronic kidney disease, end stage renal disease, and hypertension
• Risk of rejection of kidney
• Risks directly related to KPD:
• Pre-transplant: One or more donors or recipients are unable to proceed for either medical or psychosocial reasons
• Intra-operatively: Donor or recipient develops complications, making it unsafe to continue with the surgery. In this case, one recipient may not receive a kidney
• Postoperatively: Risks incurred with shipping of kidney such as prolonged cold ischemic time due to logistical problems, natural disasters, etc., resulting in non-functioning kidney transplant
• Financial: Financial loss incurred if donor travels to a transplant center for surgery and surgery is cancelled
• Psychosocial: Emotional risk due to complications to the donor or recipient, failure to complete exchange, or failure of the organ to function as expected

More Information

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.

Physicians

Physicians offering this service include:

• Brennan, Todd V.
  • Surgery / Abdominal Transplant
• Butterly, David W.
  • Medicine / Medicine-Nephrology
• Ellis, Matthew J.
  • Medicine / Medicine-Nephrology
  • Surgery
• Greenberg, Arthur
  • Medicine / Medicine-Nephrology
• Patel, Uptal D.
  • Medicine / Medicine-Nephrology
  • Pediatrics / Pediatrics-Nephrology
• Ravindra, Kadiyala V.
  • Surgery / Abdominal Transplant
• Smith, Stephen R.
  • Medicine / Medicine-Nephrology
• Vikraman, Deepak
  • Surgery / Abdominal Transplant

Locations

This service is available at:

• Duke University Hospital
  2301 Erwin Road, Durham, NC 27710