Putting Control in the
Transplant Program’s Hands
BioMatrix takes a different approach to Kidney Paired Donation (KPD).
It is universally understood that the addition of compatible pairs in a KPD program makes a significant impact and creates more and better opportunities for matches with incompatible pairs, yet there are significant drawbacks of doing so in a national system. Recognizing this, BioMatrix KPD program offers our advanced matching application to transplant centers for use in their individual institutions to instantaneously evaluate potential pairings within their own system, greatly expanding living donor programs.
In addition to the single center KPD approach, BioMatrix KPD sharing program offers the ability to consider potential pairings with other participating transplant centers regionally, and nationally, with on-the-fly automatic anonymization and aggregation features.
BioMatrix KPDs reach has expanded individual transplant programs by increasing their internal pairings as well as developing geographic cooperation, both domestically and internationally.
The BioMatrix Paired Donation team is a highly specialized group of professionals supporting your transplant program’s needs.
The support team includes:
Enhancements and upgrades to the software capabilities are never static
Medical and Scientific Review Board
Available to support and offer expertise
Clinical Support Staff
Provide training, tools, and assistance for exchanges, professional and patient/family education, desensitization identification with protocol assistance and follow-up
Contact us to learn more about our Paired Donation Program!
Frequently Asked Questions
What is Kidney Paired Donation (KPD)?
Kidney Paired Donation (KPD) is a means to assist donor/recipient pairs to find another pair(s) with whom they can exchange kidneys for a more favorable compatibility. If you have a willing donor, but they can’t donate to you directly, they still can help you potentially receive a living donor kidney transplant though a Kidney Paired Donation Program.
Why are there KPD programs?
Since the demand for kidney transplantation continues to increase and far exceed the supply of deceased donor kidneys, the transplant community identified a way to utilize willing live donors to achieve more transplants. Pairs who are compatible are encouraged to join, as are Non-Directed Donors (sometimes known as Altruistic or Good Samaritan donors). Non-directed donation is when a healthy living person donates a kidney to someone they do not know.
Why participate in a KPD Program?
If you found out that you are incompatible with your recipient, you still have the potential to help your recipient by entering a KPD Program. This gives your recipient another option for a possible kidney transplant than only being listed on the deceased donor wait list. In addition, it still gives them the potential to receive a living donor kidney transplant which research shows has a better long-term survival than a deceased donor kidney transplant.
How can I participate in a KPD Program?
For a recipient to be enter a KPD Program, they must have a willing live donor. Most donor/recipient pairs are entered because of blood group and/or immunological incompatibilities. Other pairs may be seeking someone closer in age, size, or some other medical indication. In addition to pairs, non-directed donors can be entered.
All donors and recipients must undergo a complete standard evaluation and approval by the participating transplant centers before they can be entered into a KPD Program. Once entered, compatible pairings are identified using computer software. The software maximizes the number of matched pairs while providing additional consideration for specific populations such as children and highly sensitized recipients.
It makes sense that an incompatible donor/recipient pair would enter a KPD Program, but why should a compatible pair consider joining?
The more pairs who are in the pool, the better the chances for finding exchanges. Therefore, many compatible donor/recipient pairs are encouraged to join a kidney paired donation program. In exchange for participating, there is a search for a “better” kidney for the recipient. This could be a better tissue(s) match, a donor who is younger than their compatible donor, and/or a donor who is closer in size to the recipient.
Some compatible pairs choose to join for altruistic reasons. In most cases, if no better pairing is found in a reasonable amount of time, the compatible pair is scheduled for their surgeries with one another.
How is it determined if I am compatible with my recipient?
Initial testing between a donor and a recipient is to determine blood group compatibility. In the United States, approximately one of every three donors is blood type incompatible with their intended recipient. Next, testing is done to determine immunological compatibility. This testing defines if there are no barriers (negative crossmatch) or if there are barriers and how strong these barriers are (positive crossmatch).
Recipients may develop immunological barriers making it more difficult to accept a kidney transplant. Recipients who have these barriers are called “sensitized” patients. Sensitization occurs by having exposure to tissue that is non-self. The dominant causes are a history of a previous transplant, pre-transplant blood transfusions, or a history of pregnancy.
Testing is done on a recipient to determine if they are sensitized and if so, the degree of their sensitization. How strongly a recipient is sensitized helps transplant centers determine how difficult it may be to find an immunologically compatible donor.
Are there treatments available if a recipient is sensitized?
Yes. Desensitization therapies are available to help lower a transplant candidate’s immunological response and increase the chance of getting a kidney transplant sooner. Successful desensitization could potentially allow a recipient three opportunities for kidney transplant: with their original living donor, with a deceased donor, or with a donor from a kidney paired donation program. The transplant team will determine the need for desensitization therapy and if your recipient is a candidate.
How does a kidney transplant compare to dialysis?
While dialysis is a lifesaving treatment, it basically just removes waste and excess fluid, while a functioning kidney does this and much more. Dialysis only offers about 10% of what a functioning kidney does. Over time, this can have a significant impact on the body causing other serious health problems and complications including: Heart Disease, Anemia, Bone Disease, Nerve Damage, Infection, High Blood Pressure.
When is the best time to donate?
Research shows that a transplanted kidney works longer the less time that is spent on dialysis or by avoiding it all together. As wait times for a deceased donor kidney transplant continue to increase, having a living donor is the most common and best way to get transplanted and require little or no dialysis.
A transplant from a living donor is preferable to a deceased donor for many reasons including improved kidney function.
How does a KPD Program work to find pairings?
Once a pair, or non-directed donor, is entered into a KPD Program, compatible pairings are identified using computer software. The software maximizes the number of matched pairs while providing additional consideration for specific populations such as children and highly sensitized recipients. Once a match is found, the transplant center(s) involved will review records and crossmatch to assure compatibility. Once approved, scheduling for the exchange can take place. If an exchange is happening between different transplant centers, most times the donor has surgery at the transplant center where they were evaluated, and the kidney is transported to the paired recipient’s transplant center for transplantation to take place.
In most cases, the recipient and donor who entered the KPD Program together will have their surgeries the same day when there is an exchange. An exception to this is when a “chain” is started by a Non-Directed Donor (see figures 1 & 2). In these cases, the surgeries for the donor and recipient that entered the KPD Program together may not occur simultaneously.
What are the benefits of Kidney Paired Donation (KPD)?
The benefits of KPD are:
1) Living donor kidneys have a better long-term survival than deceased donor kidneys
2) Avoids or lessens the need for desensitization for blood group and/or immunological barriers
3) More opportunity for transplantation versus only waiting for a deceased donor transplant
4) Leaves more deceased donors available for recipients who don’t have a living donor option
What are the next steps to participate in a KPD Program?
All donors and recipients must undergo a complete standard evaluation and approval by the participating transplant centers before they can enter a KPD Program. By taking this step, you have:
1) Increased the opportunities for a potential transplant for your incompatible recipient
2) Given your incompatible recipient an opportunity to still receive a living donor kidney
3) Provided your compatible recipient an opportunity to find a “better” living donor kidney
4) Helped someone else discontinue dialysis or avoid it all together
5) Saved more deceased donor transplants for those who do not have a living donor