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    When Do You Consider Kidney Paired Donation for Compatible Pairs?

    by Steven Katznelson, M.D., medical director, Kidney Transplant Program, California Pacific Medical Center and Laura Miyashita

    Paired DonationKidney paired donation (KPD) is an exciting new way that might make a living donor kidney transplant available for an individual on the transplant wait list with an incompatible living donor(s). “At California Pacific, we have also begun to consider KPD for some compatible living donor pairs,” says Steven Katznelson, M.D., medical director of the Kidney Transplant Program. “The principle here is that with matching technologies already used in ‘swap’ programs, it may be possible to find an even better match for a recipient than his or her compatible donor offers.”

    Paired Donation Opportunities

    What could constitute a “better match” than the compatibility of a living donor and recipient? According to Katznelson, the Kidney Team would consider paired donation for compatible pairs when they can find the recipient one of the following:

    • a significantly younger donor

    • a better HLA-matched donor

    • a donor kidney from a bigger donor (this is most applicable to large recipients who have small compatible donors)
    “In all of these scenarios, the anticipated outcome of the transplant may be better than that offered by the compatible donor,” Katznelson explains.

    In 2009, a compatible living donor pair with a 100 pound weight difference inquired about whether a paired donation transplant might help identify a donor closer in size to the recipient. (see article: Paired Transplant Brings New Outlook to Redding Man) Katznelson describes, “At the request of the pair, we entered them into our KPD software and identified an incompatible pair whose donor was much closer to the recipient’s size. Although the transplant between a smaller donor and a larger recipient would have been very successful, we felt the chance of success would be even greater with the larger donor. We completed the two-way paired donation and both donors and recipients are doing extremely well.”

    The Kidney Team continuously looks for paired donation opportunities for the scenarios described above. Additionally, feel free to tell the Kidney Team if you are a recipient with a compatible donor and interested exploring paired donation due to the above scenarios.

    article from April 2010 Kidney Review newsletter