The idea of paired kidney donation was first described in 1986 by Rapaport [1, 2].  Since then, paired kidney donation, or better known as kidney “swap,” has been implemented in countries such as South Korea, the Netherlands, Canada, and recently, the United States.  Paired donation in the United States is coordinated by a number of private regional and national programs, in addition to a pilot program developed by the United Network for Organ Sharing (UNOS).  Among the private programs are the Alliance for Paired Donation, National Kidney Registry (NKR), the John Hopkins Paired Exchange Program, the Paired Donation Network, and the North Central Donor Exchange Cooperative as was recently described in an AJKD paper by Akkina et al.

Although many programs enabled incompatible pairs to be transplanted while advancing the science and acceptance of paired donation in the medical community, the NKR has taken the success of paired exchange to a new level in the public eye.  On February 18^th, The New York Times published a story on the largest kidney “swap” in the world orchestrated by the NKR, where one altruistic donation resulted in 30 patients receiving kidney transplants from 30 living donors across the country.  Whereas the types of donations used by the NKR have all been previously described, never have they been performed more efficiently.  Although no large medical publications have come from the NKR, they may have performed an equally important service to the transplant community by demonstrating to medical professionals and the public alike, the true power of paired kidney donation in one of the most read publications in the United States.  In fact, within the week after the story was published, visits to the NKR website increased from 150 to over 5,000 per day.  They have received interest from many new transplant centers, and from over 200 potential donors and recipients interested in participating in paired exchange (personal communication from Garet Hil, founder of the NKR).  The story has been covered in ABC news, and has received at least 37 other media citations.  There has also been wide coverage in the nephrology blogosphere, including popular sites such as Renal Fellow Network, The Kidney Doctor, and Precious Body Fluids.

In a world with such a dramatic shortage in lifesaving organs, it is prudent that patients with healthy and willing living donors are given every option to facilitate transplantation regardless of compatibility or blood type.  Hopefully, the publication of breakthroughs in paired exchange, such as that of the NKR in The New York Times, will help educate both physicians and patients of the benefit and power of paired kidney donation.

Vinay Nair, DO
eAJKD Advisory Board member

References:

1. Rapaport, F.T.: The case for a living emotionally related international kidney donor exchange registry. Transplant Proc 1986; 18: 5-9

2. Rapaport, F.T. and R. Cortesini: A new approach to current problems in organ donation for kidney transplantation. Contrib Nephrol 1986; 51: 1-9