What are paired kidney exchanges?

Increasingly, the arrangement of paired exchanges, or "donor swaps," is facilitating transplants where matches would not have been possible. A paired exchange consists of two (or more) kidney/donor recipient pairs whose blood types are not compatible or when the recipient has antibodies against their donor. The recipients trade donors so that each recipient can receive a kidney with a compatible blood type.

The transplant programs of NewYork-Presbyterian Hospital are national leaders in the performance of multiple paired living donor kidney transplantation. Since 2004, the Hospital has performed many two-way swaps, which require four simultaneous operations, as well as several three-way, four-way, and even a six-way exchange. These arrangements allow some patients to receive a transplant who otherwise would not have had a compatible donor. The Hospital also pioneered the Never Ending Altruistic Donor (NEAD) Chain, in which one altruistic living kidney donor, willing to donate to any patient awaiting transplantation, begins a chain of kidney transplants that otherwise would not be possible.