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What Is a Paired Kidney Exchange?

A paired kidney exchange is a program that matches the most compatible donors and recipients for a living kidney donation based on blood type and other biological factors. It helps us ensure that recipients have the lowest risk of reacting to or rejecting a donor kidney. It also helps to decrease long-term infection and cancer risk as the recipient may benefit from lower doses of anti-rejection medications.

How Does Paired Kidney Exchange Work?

Paired kidney exchange may involve two types of scenarios:

  • Classic paired donations: We may match two donor/recipient pairs who are incompatible by “trading” donors.
  • Donor chains: We may cross-match more than two donor/recipient pairs to find the most compatible match possible. Several donor/recipient pairs may swap recipients so that each recipient receives a compatible kidney.

In the chart on the right, the first pair, a mother and her daughter, are incompatible. This means they don’t have matching blood types. The second pair, two brothers, also don’t have matching blood types. In this exchange, the daughter (Elizabeth) donates to the brother (Paul) in the second pair. The other brother (John) donates to the mother (Mary) in the first pair.

After all donors and recipients have been matched, the transplant team can then schedule the kidney transplant surgeries.

Why Choose University of Utah Health for Paired Kidney Donations?

At U of U Health, we are part of the National Kidney Registry and the Alliance for Paired Kidney Donation. Being involved in these national programs expands our donation pool so that we find the most compatible match for each recipient.

We can do paired kidney exchange internally, meaning we match you with a donor/recipient pair within our program. Or we can do kidney exchanges and paired donations externally by partnering with local centers. We can even put donors and recipients into national pair exchange programs to see if we can find a more ideal donor somewhere else in the country.

Why Should I Participate in the Kidney Exchange Program?

Kidney exchange programs allow us to find the most compatible matches available. Finding an optimal match lowers the risk of organ rejection and increases the chances that the kidney will function well long-term.

We encourage all donors and recipients to participate in a kidney exchange program, even if they have compatible blood types. For example, you may technically be a compatible match for a loved one but have a much smaller body size. Although you are the right blood type, your kidney function may not be adequate long-term for someone with a larger body size. Through kidney exchange, we can find a match that offers better chances of optimal long-term results.

We will discuss the benefits of participating in the kidney exchange program with all our donor/recipient pairs. Joining the program will always be your choice.

Kidney Paired Donation Wait Time

Participating in a paired donation program doesn’t delay kidney transplant surgery. We usually find out within a few weeks if there is a better available match.

Non-Directed Donation

A non-direction donation is when a donor wants to give a kidney to someone who needs it. It’s often called a “good Samaritan” donation because the donor typically doesn’t know the recipient.

We can often use a non-directed donation to start a kidney chain. This means that instead of helping just one patient, we can match multiple donors and recipients.

Resources for Our Patients

Financial Resources

Are you considering living organ donation but are worried about costs of care? Learn more by reading the American Society of Transplantation's Live Donor Financial Toolkit.

View the Financial Toolkit

Independent Living Donor Advocate (ILDA)

During the entire evaluation process, the independent living donor advocate (ILDA) is available to help make sure your rights as a donor are protected.

Meet the Independent Living Donor Advocate

To Start the Living Kidney Screening Process

Begin your journey towards becoming a living kidney donor.

Start the Process

What to Expect: Living Kidney Donation

Find out what to expect throughout the process of becoming a living kidney donor.

Read the Guide

Meet Our Patients & Donors

Hear From Our Specialists