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Kidney donor exchange programs catching on

A new Living Donor Kidney Exchange Program launched earlier this month by the New York Organ Donor Network will allow potential kidney donor-recipient pairs who are not suitable for reasons such as mismatched blood type to be matched with other willing donor-recipient pairs.
/ Source: Reuters

Say you wanted to donate a kidney to a relative, but weren’t a match. Would you donate your kidney to a stranger who could use it, in exchange for a kidney from one of their relatives that was a match to your kin?

Seems like a good idea, and such plans are being set up.

A new Living Donor Kidney Exchange Program launched earlier this month by the New York Organ Donor Network will allow potential kidney donor-recipient pairs who are not suitable for reasons such as mismatched blood type to be matched with other willing donor-recipient pairs.

“What we’re trying to really do is take advantage of the pool of willing living doors who want to donate to people they know but are physically, biologically incompatible,” Elaine Berg, president and CEO of the New York Organ Donor Network, told Reuters Health.

“Rather than saying, 'Sorry you can’t donate, goodbye,' (we can say) 'we may have this other option,'" Berg said.

Similar programs have been established in New England and Ohio as well as in the Maryland-based Johns Hopkins Comprehensive Transplant Center and the University of Chicago Hospitals.

Kidney exchange programs also exist in the Netherlands, Mexico and Korea. The announcement of the new program in New York suggests that the idea is growing in popularity.

In fact, Berg said, the network has already begun discussing extending the program outside the New York metro area in order to partner with their counterparts in upstate New York, New England and New Jersey.

Research has shown that in 90 percent of cases, kidney transplants to unrelated recipients are still functioning one year after the surgery. Transplants performed as a result of the new exchange program “will basically mirror (these) results,” Berg said.

Requests from would-be donors
Berg’s “personal motivation for pushing the program forward” was the inquiries she had received from “very frustrated” individuals who were willing but unable to donate their kidney to a loved one.

In up to 35 percent of cases, family members and friends, who are often the first to volunteer to donate an organ, are denied the opportunity to do so due to biological incompatibility, studies show. A person with type A blood, for example, is unable to receive an organ from an individual with type B blood and a person with type B blood is similarly unable to receive an organ from someone whose blood type is type A.

The new program will address this problem by allowing a type A individual, who is willing but unable to donate an organ to a type B family member or friend, to donate his or her organ to a type A individual on the kidney transplant list. In turn, a type B willing donor who was unable to help his or her type A loved one will now be able to donate a kidney to the family member or friend of the type A donor.

The two transplants would be performed simultaneously.

So far, five kidney transplant centers in the New York metro area have agreed to partner with the Donor Network.

The first paired kidney exchange transplants were performed in 2001, according to the United Network for Organ Sharing. Since then, 62 have been performed, as of May 31 of this year. Thirty were performed in 2004 alone.

Still, the waiting list for a kidney transplant in the United States is made up of more than 62,600 individuals, including 4,507 individuals in the New York metro area. Many of these potential recipients have been waiting for five years or longer.

As a result of the new program, however, transplant centers can now go back to potential donor-recipient pairs who were turned down and present them with another option. “We are eagerly looking forward to the moment we make a match,” Berg said.

Yet, despite her enthusiasm for the kidney exchange program, Berg stressed that “it really is a default program.”

“There would be no need to focus on living donors if enough people donated after death,” she pointed out.