Kidney Paired Donation and the Mayo Clinic Experience - An Update

Jun 13, 2019 | Kristin Eggebraaten | @keggebraaten

Today almost 114,000 people are waiting for an organ transplant and over 94,000 of those are waiting for a kidney. Increasing the number of possible living donors and finding innovative ways to get more people transplanted are two of the best ways to reduce this waiting list. Paired donation kidney transplant is a way to reduce the waiting list and give living donors a chance to help not just one life, but sometimes many lives.

Kidney transplants can be performed from a deceased or living donor. Living donors are often a family or friend, but they can also be anonymous, non-directed donors, meaning they are not donating to someone they know. Often, when someone wishes to donate anonymously, that donation can spark a chain of kidney transplants, a process known as paired donor kidney transplant. Generally, non-directed donors are genuinely altruistic, very giving and unselfish people.

2019-06-13 Paired Donation Update Blog

In kidney paired donation, the non-directed kidney donation goes to a recipient who had someone volunteer as their donor, but the donor was not a compatible match. That donor then “pays forward” their donation to someone else who is waiting. Living donation gives transplant patients a chance for better quality of life and a longer life. Living donor surgery can be planned, and if possible, the patient can be transplanted before dialysis is needed. Kidney paired donation is only available for living donor transplants.

Mayo Clinic performed its first paired kidney donation in 2007 with a two-way paired donation. A son desperately wanted to donate to his father, but their blood types weren’t a match. However, the son had the option to swap his kidney with someone else who had a donor that didn’t match. Mayo Clinic was able to find another donor/recipient pair that was incompatible due to antibody resistance. The pairs matched and the transplants were performed in November 2007.

Other situations offer opportunities for kidney paired donation. Even if a donor matches with their recipient, the match might not be perfect. If the donor is significantly older than the recipient, they may do better with a younger donor. Or if the donor is very petite and recipient is tall and large, participating in kidney paired donation might give the recipient more kidney volume which could bring better kidney function and patient survival.

With more than 12 years of experience facilitating paired donor kidney transplants, Mayo Clinic has now completed over 400 transplants using kidney paired donation and is hoping to complete many more in the coming years. Mayo Clinic has also established a relationship with the National Kidney Registry (NKR). Working with NKR has allowed Mayo Clinic to expand the donor pool for recipients because NKR matches living donors and recipients through a national registry with transplant hospitals throughout the United States. With a large pool of donors and recipients, more exact matches can be made, which allows for optimal long-term outcomes.

Kidney Paired Donation at Mayo Clinic by the Numbers:

More than 400 kidney transplants performed via paired donation in the past 12 years
Non directed donors created multiple chains, helping many more than just one recipient
Non-directed donors need to be at least 21 years old
The oldest living donor was in their 70s and many donors are older than age 65

Becoming a donor is a choice you need to make for yourself. You should not feel pressured to be tested or to donate. Not everyone can be a donor and not everyone should be a donor. A person needs to be medically healthy and psychosocially stable. They need to be financially stable enough to take time off work. By qualifying to be a living donor, whether for someone you know and love or just because you know there is a need, you could save the lives of many people by starting a chain of kidney transplants through the paired donor process we described. If you would like more information about kidney donation, visit our living donor toolkit.

Have you participated in kidney paired donation? Tell us about your experience!

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