NCPA - National Center for Policy Analysis


October 13, 2005

Paired organ exchange looks promising for patients needing a kidney transplant, according to researchers from John Hopkins University. In a recent study, they found the success rates from paired organ exchange transplants comparable to other live-donor transplant rates.

Traditionally in live-donor transplants, the donor and recipient are related, either as family or friends. In a paired donation, two donor/recipient pairs who are blood type incompatible exchange donors such that both resulting transplants are compatible. Thus, donor 1 can provide an organ for recipient 2 while donor 2 provides an organ for recipient 1.

Researchers say given the success of unrelated living donor transplants in general, paired exchanges should have excellent long-term outcomes. This is great news for patients seeking a donor:

  • In 1980, a candidate on the waiting list could expect a transplant within one year; currently, more than 62,000 candidates are on the national kidney waiting list, and the average waiting time is longer than five years.
  • Annually, about 7 percent of the candidates on the waiting list die; even if all potential deceased donors became actual deceased donors, there would still be a shortage of organs.
  • In the John Hopkins study, a total of 22 patients received transplants through 10 paired donations including 2 triple exchanges; the patient survival rate was 100 percent.

If these results can be generalized, broader availability of paired organ exchanges to the estimated 6,000 patients with incompatible donors could result in a large expansion of the donor pool.

However, researchers say paired organ exchanges are limited due to blood type and immunologic compatibility barriers. The small number of eligible donor/recipient pairs at each center also makes finding a matched pair difficult. Researchers say regional or national matching programs would make finding pairs more probable.

Source: Robert A. Montgomery et al., "Clinical Results from Transplanting Incompatible Live Kidney Donor/Recipient Pairs Using Kidney Paired Donation," Journal of the American Medical Association, Vol. 294, No. 13, October 5, 2005; and Arthur J. Matas, and David E. R. Sutherland, "The Importance of Innovative Efforts to Increase Organ Donation," Journal of the American Medical Association, Vol. 294, No. 13, October 5, 2005.

For Montgomery text:

For Matas text:


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