The increasing need for kidney transplants has led to innovations such as donor exchange programs. These programs offer transplant recipients with incompatible donors an opportunity to receive a compatible kidney. They also provide an alternative to costly desensitization protocols that have unproven long-term outcomes. Donor exchange programs have multiple options, including simple 2-pair exchanges, more complicated domino exchanges, or chain donations. The United States currently is limited by regional programs that provide for kidney donor exchanges. However, with the increasing public interest in and need for kidney transplants, general nephrologists will be approached with questions about these donor exchange programs. The goal of this review is to discuss donor exchange programs, including their role in expanding the donor pool, various types of exchanges, regional centers that provide these programs, and the process involved in patient enrollment. General knowledge of donor exchange programs will help providers in discussing options with patients approaching end-stage kidney disease and transplant.
Bibliographical noteFunding Information:
Support: Dr Akkina was supported by a research grant from the American Society of Transplantation and the National Institute of Diabetes and Digestive and Kidney Diseases , award no. K23DK084121 . Dr Israni is a Robert Wood Johnson Foundation Physician Faculty Scholar. Dr Kim is supported by the Clinician-Scientist Training Award , Canadian Institutes of Health Research .
- Donor exchange
- incompatible kidney donor
- kidney transplantation