UW Health Transplant Kidney Exchange Program


UW Health surgeons perform transplant procedures working with living donors for kidney transplants. Advantages to living donation include a scheduled procedure, better conditions for the surgery, improved patient survival and better long-term function of the transplanted organ.


The Paired Exchange Program


UW Health Transplant paired kidney exchange program diagram


Paired kidney exchange.

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In the past, a recipient candidate of an incompatible living donor had to opt only for a deceased donor kidney. Through a national kidney exchange program, the UW Health Transplant Program offers options for patients who have an incompatible donor, making it possible for them to receive a living donor kidney transplant. The exchange program helps the deceased organ donor organ shortage by using organs from living donors who may otherwise be unable to donate, and helps patients who may have difficulty finding an appropriately-matched living donor.


With more than 50 transplant centers participating in this national program, the donor pool is greatly expanded which significantly increases the opportunity to find a compatible donor for a recipient.


How the Process Works


The criteria and medical testing for each donor and recipient who are interested in the paired exchange program is carried out in the same manner as it would be for any living donor and recipient at the UW Health Transplant Program. First, a thorough testing and evaluation process is completed for both the donor and recipient. If they are found to be healthy candidates for donation and transplantation, but are incompatible to each other, they will meet with a living donor transplant coordinator to discuss the kidney exchange program.


When new donors and recipients are listed with the kidney exchange program, the program will run a national match-run list to identify other donors and recipients who may be compatible. If a compatible donor/recipient pair is located, our transplant surgeons will have the option of accepting or declining that specific match. Once accepted, donors are given the opportunity to donate a kidney to the recipient who matches their kidney, while their intended (incompatible) recipient receives a kidney from someone else. This kidney exchange enables both recipients the opportunity to receive a live donor kidney transplant.


Non-Directed (Humanitarian) Donation


UW Health Transplant kidney transplant donor chain


Donor chain. View full image

In a non-directed donation, a donor contacts the UW Health Transplant Program to express their interest in donating their kidney. These donors do not have a specific recipient identified, but will donate to a recipient who is a good medical match.


Most recently, non-directed donors have begun initiating donor chains. These multi-tiered chains of donors and recipients have the potential to facilitate thousands of additional living donor transplants at much higher compatibility levels.


Donor Chains


Donor chains are initiated by a non-directed donor, greatly multiplying the potential for kidney exchanges. Because they involve a non-directed donor, and many donors and recipients, donor chains can include recipients who have high antigen levels who may have been unable to find a compatible donor. Including more people in the chain allows for better donor/recipient matches, which provides a way for poorly matched donors and recipients to improve their donor match compatibility.


A closer match with the donor allows the transplanted kidney to function longer in the recipient, which creates fewer antibodies and often means less medication for the recipient. Through a donor chain, a non-directed donor can help dozens of people receive a transplant instead of just one person. To maximize the gift of life provided by a non-directed donor, kidney registries attempt to start a donor chain whenever a non-directed donor enters the registry. One donor chain has the potential to facilitate up to 36 transplants per year.