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Living Kidney Donation

Types of living kidney donation

Directed donation

When you know who you wan​t to donate your kidney to it’s called a directed donation. That person can be related or unrelated to you.

  • Related: You’re biologically related to the recipient. The recipient (person getting the kidney transplant) could be your parent, child, grandparent, grandchild, brother, sister, or any other blood relative.
  • Unrelated: You’re not biologically related to the recipient. The recipient could be your friend, partner, spouse, or someone you know. Another example of an unrelated directed donation is when you hear about someone who needs a kidney, and you decide you want to donate your kidney to them even if you’ve never met before.

Non-directed donation or anonymous donation

This is when you’re interested in donating to someone in need, but don’t have a specific person to give your kidney to. You don’t know who the recipient would be.

For anonymous donations, your identity and donation are kept private. The recipient won’t know who donated the kidney.

What is a kidney paired donation (KPD)?

When you direct your kidney to a specific person, tests are done to make sure the donor and recipient pair are a good match. Sometimes, the donor and recipient pair don’t match. The 2 most common reasons for not matching are when the blood group or the tissue type aren’t alike (compatible). This is called an incompatible pair. If you’re willing to donate and you aren’t a match, there are other possibilities.

When this happens, the pair may want to think about a paired exchange, also called kidney paired donation (KPD). This allows donations to happen with other pairs who are also incompatible.

Canadian Blood Services describes a paired exchange like this:

“Imagine you want to donate one of your kidneys to a family member or a friend who needs a transplant.

However, medical tests show that you are not a good match for them. Another potential donor and their transplant candidate are in the same situation.

Turns out you are a match for the transplant candidate in the other pair, and the potential donor in that pair is a match for your friend or family member.

Swapping donors in these two pairs makes two transplants possible.”

​CBS 2022 Kidney Paired Donation Program

These exchanges can be matched just between the 2 pairs (4 people) or between multiple pairs (many people). Your local Living Donor Program registers you through a national registry at Canadian Blood Services.​​

Sometimes, anonymous donors are added, forming a chain of pairs.

This image shows an example of how a closed chain type of kidney paired donation works:

Infographic showing how a paired exchange can take place between 3 pairs of donors and recipients.

Credit: ​Canadian Blood Services. (2018) CC.BY.NC.SA 4.0​​​

In a closed chain paired exchange:​

  • donor A wants to donate a kidney to transplant candidate A, but they aren’t a match
  • donor B would like to donate a kidney to transplant candidate B, but they aren’t a match
  • donor C wants to donate a kidney to transplant candidate C, but they aren’t a match
  • however, donor A is a match with transplant candidate B, donor B is a match with transplant candidate C, and donor C is a match with candidate A.
  • an exchange is then done among the 3 pairs

Since 2009, there have been over 740 living donor kidney transplants in Canada through KPD. These transplants were not possible without this program. All programs have a goal of increasing living donor kidney transplants and cutting the wait list for deceased donor transplants. KPD is a valuable option for many donor and recipient pairs who aren’t a match.

To learn more about kidney paired donation, go to Living Donation Options: Direct Donation, Paired Exchange, Closed Chains, Domino Chains (video), Kidney Paired Donation Program.

After reading this information, if you have any questions about kidney paired donation, please call the Living Donor Program closest to you:

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