California Pacific's Paired Kidney Donation Program Busiest in U.S.

The availability of kidney donors who can support the increasing transplant demand has frustrated the transplant community for decades. “Individuals who have a living kidney donor have the best outcomes after transplantation, but unfortunately nearly 50% of identified living donors cannot donate mainly because of blood type or crossmatch incompatibility,” says Steven Katznelson, M.D., medical director of Califoirnia Pacific’s Kidney and Pancreas Transplant Program.

To address the organ donor shortage, California Pacific Medical Center implemented a Paired Kidney Donation (“swap”) Program in 2007. Since then, the Medical Center has rapidly become perhaps the busiest single center paired donation program in the country, says Katznelson.

Program Matches Incompatible Recipients and Donors

With paired kidney donation, pairs of incompatible recipients and donors are matched with other such pairs, leading to two or three successful transplants (see diagram). Transplant recipient David Jacobs developed Silverstone Solutions Matchmaker®, a novel computer software that is the cornerstone of California Pacific’s Paired Donation Program, following his transplant. In a desire to help other patients like himself, Jacobs has dedicated the last three years to this program.

Living Donor Transplants Increase

“In total sixteen patients—who otherwise would have had to endure long waiting times on our kidney transplant waiting list—have been transplanted in our Paired Donation Program,” says Katznelson. This includes five two-way exchanges and two three-way exchanges. According to Katznelson, “All of the recipients have excellent kidney transplant function and all donors are also doing well.”

One of the three-way exchanges involved two recipients at California Pacific and a third recipient at Johns Hopkins Medical Center in Baltimore, Md. A donor kidney removed at California Pacific was flown by private jet to Baltimore for transplant in the Hopkins recipient. “This was the first time that a living donor kidney had been shipped such a great distance,” says Katznelson. “Hopefully this event will pave the way for similar life-saving procedures when thousands of miles separate the transplant donor and recipient.”

For individuals with an incompatible donor, the Kidney Team has found that the Matchmaker software provides a 20% chance of identifying a match. Katznelson says, “Although paired donation certainly is not an answer for all incompatible living donor pairs, it offers an exciting new option for many who would otherwise wait years for a transplant.”

If you have additional questions regarding California Pacific’s Paired Kidney Donation Transplant Program, please contact us via email at kidneypair@sutterhealth.org.