Advantages of Paired Donation

• Deceases time on deceased donor organ wait list
• Decreases time on dialysis
• Decreases healthcare costs significantly
• Increases healthy organ procurement
• Increases short and long-term success rates

Today, there are over 70,0001 people on the kidney transplant list waiting for a deceased donor organ. The average wait time for a kidney is three to six years depending upon blood type, region and other factors. Many of these transplant candidates will die before they receive an organ, and the transplant list continues to grow at an alarming rate-- almost 10% annually for the past decade.2 The financial resources required to care for these patients places an enormous burden on an already overtaxed medical system. Additionally, the longer a transplant candidate remains on the list, the longer they remain on dialysis, which significantly increases the likelihood of developing morbid disorders associated with prolonged dialysis and raises the cost of care astronomically for each patient.

Paired donation is an innovative approach that utilizes healthy, living donor organs when the intended recipient is incompatible with his or her donor.  The basic process is to match two incompatible donor/recipient pairs with an alternate compatible pair.

By increasing the availability of viable living donor organs, more people can be transplanted, lessening the impact on the deceased donor organ waiting list and allowing end stage renal disease patients the opportunity to have a living donor from a less restrictive pool of organs. Additionally, research shows that living donor kidneys are preferable to deceased donor kidneys. The latest five-year graft survival rate for deceased donor kidney transplants is 66.7%, while the rate for living donor transplants is 80.2%.3

The notion of paired donation has been pioneered at a number of institutions, most notably the Johns Hopkins University Incompatible Kidney Transplant Program, who performed the first paired donation kidney transplant in the United States in 2001.  However, despite all its obvious and important advantages, relatively few paired donations have been performed nationally.4

The biggest hurdle to paired donation is the painstaking process of combing through all the recipient/donor data and finding a match. This requires the ability to analyze in real time a potential incompatible donor pair with all other pairs in the pool in real time while evaluatiing their blood types, antigen avoids, age differentials and more. When one multiplies the time and cost required to complete this analysis for every incompatible pair on the list, it‘s no surprise why so few successful paired donation transplants have occurred.

Silverstone Solutions has developed a solution for this problem, Matchmaker, a clinical application designed with advice from leading nephrologists, that utilizes a suite of custom algorithms to generate paired donation matches for an entire pool of potential recipients. Matchmaker can perform the difficult task of co-matching two interested donor/recipient pairs from a selectable pool of alternative donor-recipient pairs. It also evaluates key immunologic parameters including blood type, 14 specific antigens, age and degree of compatibility with other donor-recipient pairs on the list. Finally, it optimizes the pairings to yield the greatest number of transplants for a given pool.  Matchmaker can provide results in minutes that would not be possible by hand. Matchmaker is also a robust and flexible tool that allows nephrologists and transplant clinics to directly manipulate the pairs to their exact requirements. Triple swaps are also readily analyzed. For more information about our products, please review our Product Overview page.

1. Source: United Network for Organ Sharing, January 2007
2. Source: OPTN/SRTR as of May 2, 2005
3. Source: 2005 OPTN/SRTR Annual Report, Table 1.13.
4. As of April 25, 2005 – Johns Hopkins transplanted 51 patients via paired donor exchanges, the most of any organization in the country.

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