Have you ever heard of a kidney paired exchange? It may also be known as a kidney swap. The whole process is fairly easy to understand and allows patients to receive a kidney transplant within a year instead of waiting the traditional 2 to 4 years.
The first step in this process is for the patient in need of a kidney transplant (transplant recipient) to find a family member, friend or anybody (some people find strangers) willing to give an organ directly to him. It is called a living donation. A perfect match would be the best case scenario and they will be able to go ahead with the kidney transplantation. Before 2008, if there was no match, that was it, no transplant. Now, there is more hope. Two transplant recipients and living donors from the same center can be matched. If that is not a possibility, the potential kidney donor and the transplant recipient, providing everybody consents, will be put on a national list for a kidney swap.
The objective is to pair the transplant recipient and his donor with another transplant recipient and donor in the same situation. This is what a kidney swap is all about. The end result is the same: both transplant recipients get a new living donor kidney and both donors have given a kidney. This process opens more doors and allows more transplantations to take place because otherwise nothing would have happened without a match.
Sometimes it takes more than 2 donors to make a swap happen. In other times it takes a much bigger chain. The record in the US was a chain of 34 kidney transplants involving 68 people happening over a period of several months. A software is used to find the kidney pairing but I still cannot imagine all the coordination needed in order to make it happen. People were scattered everywhere in the country. From California to New York along with Washington (state) and Texas among the states involved.
One of the organism in charge of facilitating those paired exchange is the National Kidney Registry (NKR). They have helped arranged over 2,800 kidney transplants since 1998 and have over 60 transplant centers using their services in the USA. Their average wait time is usually less than 12 months compared to the 51 months for the traditional deceased donor wait list. The wait time is driven by the antibody matching. The less antibodies, the shorter the wait time. Not all kidney transplant centers participate in the program. A program has to apply with the Registry to join and meet certain criteria and most importantly; be willing to make the effort to help arrange kidney transplants involving more logistics.
All this information might be confusing to the patients and their family but the nice thing about transplant in the US is that it is very transparent and a lot of information can be found on the internet.