What are paired kidney exchanges?

Paired kidney exchange is an option for kidney recipient and donor pairs who are not blood and/or tissue-type compatible. With paired kidney exchange, kidneys are exchanged between two incompatible pairs to make two compatible living donor transplants. While it may not be possible to find a compatible donor-recipient pair for everyone, enrollment in this process can expand the opportunity to receive a transplant or donate a kidney.

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.

Continue Learning about Kidney Donation

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.