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John C. McDonald Regional Transplant Center Performs Its First Kidney Paired Donation

Nov 10, 2017

The John C. McDonald Regional Transplant Center at Willis-Knighton has performed its first kidney paired donation (KPD), under the auspices of the United Network of Organ Sharing (UNOS) pilot program and as part of the nonsimultaneous extended altruistic donor (NEAD) chain.

The chain was initiated by an altruistic donor at Oschner Medical Center in New Orleans, which resulted in a living donor from Oschner donating to an incompatible husband-wife donor-recipient pair at Willis-Knighton. The wife successfully received the kidney transplant and two weeks later, her husband donated the kidney, which was flown to Ann Arbor, Mich., to continue the chain. The Michigan donor donated to the recipient in New Orleans to complete the chain. Even though there is a risk of donors reneging once their intended recipients have received the transplant, it rarely happens and this accounts for success of NEAD chains.

The kidney paired donation program, which started in the early 2000s, now accounts for more than 10% of all living donor kidney transplants performed in the country. The kidney paired donation can take the form of conventional two-, three- or even four-way swaps to more complicated chains of transplants that are typically initiated by an altruistic donor. The altruistic donor donates a kidney to a recipient with an incompatible donor. The incompatible donor in turn donates to another recipient whose incompatible donor donates to yet another pair. These chains of transplants can happen simultaneously or in a stepwise nonsimultaneous extended altruistic donor (NEAD) chain. These chains are done more commonly and facilitated by powerful mathematical modeling and matching algorithms. 

In the United States, based on distribution of blood group antigens, there is a 35% chance that any two individuals will be incompatible for living organ donation due to blood type. Approximately 6,000 patients on the kidney transplant waiting list have a medically acceptable, willing living donor but are incompatible by blood type or cross-match with the intended recipient. Kidney paired is an approach in which incompatible pairs exchange donors so that each recipient receives a compatible organ.

“The availability of a kidney paired donation program will enormously help patients at our transplant center,” says Dr. Gazi Zibari, program director of the transplant program at Willis-Knighton. The John C. McDonald Regional Transplant Center at Willis-Knighton has performed more than 2,500 transplants in the last 30 years. More than 60 kidney transplants are expected to be performed in 2017 at the Center. 

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