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kidney transplant donor, organ recipient

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What is Paired Donation Exchange | Paired Donation Process


Recipient and Donor Criteria
For recipients and their donors to be eligible, they must meet the following criteria:


  • Each recipient must have at least one donor who is healthy
  • Donors must be at least 18 years of age
  • The recipient’s donor must have the wrong blood type or have a positive cross match test


Medical Evaluation and Tests for the Donor 

  • History and Physical Exam
  • Blood Work: Blood count, tests for hepatitis and other viruses
  • Urine Test


Additional Medical Testing that may be Required

  • Chest X-Ray and Electrocardiogram
  • Pap smear in women over 40 years of age
  • Pregnancy test in women of childbearing age
  • Test for blood in the stool for all patients over 50 years of age
  • A renal ultrasound for donors who have a history of Polycystic Kidney Disease


Medical Evaluation for the Recipient 

The medical evaluation of the recipient is exactly the same as if the recipient were going to be listed for a deceased donor kidney. This part of the usual transplant process is not changed for paired donation. The recipient evaluation, however, must be complete before the recipient is registered in the paired donation program.


Once the donor and recipient evaluations are complete, both will be asked to sign a consent form to participate in the paired donation program. At this time, the details of how the program works will be provided and all questions answered.


Donors and recipients are registered in the computer-matching program after signing the consent form.


Computer Matching Process 

  • The computer matching process timeline is generally facilitated once a week or as mandated by updated blood work on the recipient who may be receiving desensitization or the addition of new donor/recipient pairs registered.
  • Once the computer match run is completed for that cycle, all potential matches are reviewed scientifically and medically to evaluate the results to ensure they are medically acceptable.
  • All matches that are found to be medically acceptable are then referred and communicated to the individual transplant centers for actual cross match testing.


Cross Match Testing and Final Evaluations 

  • Matched pairs undergo cross match testing (blood tests) by the transplant programs that will be performing the surgeries.
  • If the cross match tests are medically approved, the surgical transplant team will discuss the paired donation process with the donor and the recipient. If you have any questions regarding the exchange process, please address this with your transplant coordinator.
  • Final consents are obtained from donors and recipients to proceed with the paired donation transplant surgery.


Final Preparations and Transplant Procedures

  • A date for the transplants is selected.
  • If donors and recipients involved in the paired donation transplant process express a desire to meet each other, the transplant coordinators and/or social workers can assist in those arrangements.
  • If one donor or recipient is uncomfortable meeting the other, no meeting is arranged.  Most hospital policies encourage a meeting after the transplants have been performed.