Tuesday, June 28, 2011

A NEW Twist to Kidney Paired Donations - "Perfect Matches"

Kidney Paired Donations, (KPD) A.K.A Paired Exchanges or swaps have become very popular. A KPD is when the donors of two or more incompatible donor/recipient pairs are willing to donate to the recipient of another incompatible pair.

Many hospitals do in house KPD's by matching their incompatible pairs...some hospitals have joined together with others in their area...and, there are a few organizations that have developed a "co-op" approach and have many hospitals that participate. One of the basic concepts of KPD's is that the more incompatible pairs you have in a pool, the more likely you are to find matches.

There are two national and one regional organization that "co-op" with hospitals to do KPD's. The National Kidney Registry, (NKR) www.kidneyregistry.org is doing more KPD’s than any other program. They are working with 60 transplant centers,(including the majority of the top 20 centers by 2010 transplant volume,) and have facilitated over 300 transplants since their first in February of 2008. Their transplant volume is doubling annually and expect to facilitate 260 transplants in 2011.

The Alliance for Paired Donation www.paireddonation.org is working with 80 transplant centers and have performed approximately 80 transplants since starting their program.

The New England Paired Kidney Exchange works with hospitals in Maine, New Hampshire, Connecticut, Massachusetts, Rhode Island, New Jersey and Philadelphia. Since they started doing KPD's in 2001 they have performed more than 90 transplants.

The NEW twist in KPD's is Compatible Paired Donations. In a Compatible Paired Donation, a compatible donor/recipient pair(s) is used to facilitate a transplant with an incompatible donor/recipient pair(s). The motivation for a Compatible Pair to join a KPD is to receive a better matched kidney than the one being offered by their donor. It could be a better matched HLA kidney, a kidney from a younger donor, or a kidney that is a better size. The goal is to have all recipients benefit by participating in such an exchange.

An ideal Compatible Donor/Recipient pair is one where the donor is a blood type "O", and their potential recipient is blood type "A", "B", or "AB".

If there are large numbers of people participating in KPD's, more Compatible Pairs will be motivated to join, not only to find a better matched donor, but to find a perfectly matched HLA donor. The half life of a perfectly matched living donor is 28 years, while ones that are not perfectly matched is about 18 years...a significant difference.

Not only do KPD's allow for successful outcomes for those that have a willing but incompatible donor...Compatible Pairs are participating with the hope of finding that "Perfect Match"... the NKR has already facilitated 2 "Perfect Matches."