The Living Donor Paired Exchange Program

There are two basic types of kidney donation: deceased donation and living donation. Recipients of a kidney from a deceased donor are on a waiting list and may be on the list for years before a suitable kidney from a deceased donor becomes available. Recipients from a living kidney donor typically receive their kidneys from a relative or friend who chooses to donate directly to the recipient.

What happens, though, when a living donor is incompatible with the intended recipient? Enter the Living Donor Paired Exchange Program, administered by Canadian Blood Services. This program runs a complex matching algorithm approximately once every three months, which compares the medical information on all the pairs and non-directed donors in the Registry and identifies kidney transplant opportunities. Each kidney exchange is completed in one of the following three ways:

  • Paired Exchange

Let’s say Donor A wishes to donate a kidney to Recipient A, but they are not a match. Donor B would like to donate a kidney to Recipient B, but they are not a match. However, Donor A is a match with Recipient B, and Donor B is a match with Recipient A.

kidney-exchange_pair

  • N-Way Exchange

An n-way exchange is similar to a paired exchange, except there are more pairs included and the donor of the last pair donates to the recipient of the first pair.

kidney-exchange_n-way-300x194

  • Domino Exchange

Domino exchanges begin with a non-directed donor who donates to the recipient of an incompatible pair. There can be multiple incompatible pairs in a domino exchange as you can see below with pairs A, B and C.

The exchange is complete when the donor of the last incompatible registered pair donates to a recipient on the transplant waitlist who is from the same transplant program as the non-directed donor.

kidney-exchange_domino

 

For more information, please go to the Organ & Tissue Donation and Transplantation website of Canadian Blood Services.

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