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Kidney Donor Waiting List Exchange
Kidney donors — whose blood types don't match the relatives or friends who need kidney transplants — have another option to help. A program of the Kidney Transplant Service at UCSF Medical Center allows you to donate a kidney to a patient, who has compatible blood and is at the top of the kidney waiting list for a "deceased donor" or cadaver, kidney. In exchange, your relative or friend moves up on the waiting list for a deceased donor kidney.
The program, called the Live Donor to Deceased Donor Waiting List Exchange Program, is a way to benefit a loved one, even if you don't have a blood or tissue type match.
This is a way to potentially reduce the wait time for a deceased-donor kidney, which in the Bay Area ranges from three to six years and is primarily dependent upon blood type.
Once the donation is made, the donor's relative or friend will move to a position on the waiting list equivalent to that of the patient who received the live donor kidney. The relative or friend would have the right of first refusal for any offered deceased donor kidney after reaching the top of the list.
How the Program Works
If you are interested in more information or want to participate, you and your loved one will talk with a transplant doctor or coordinator. If you decide to proceed, your diagnostic evaluation and the evaluation of your loved one will begin.
The kidney recipient must pass all screening tests and be ready for the transplant. The donor also will undergo a series of tests to confirm that he or she can safely donate.
Once the donor and recipient evaluations are completed, the donor kidney will be offered to a patient on the deceased donor waiting list and the transplant performed.
After the surgery, the donor's loved one will move to a higher position on the deceased donor waiting list, a position equal to that of the patient who received the donor's kidney. For example, if the donor's kidney went to the fourth patient on the deceased donor list, the recipient would move to the fourth spot on the list for his or her blood group and would receive kidney offers once at the top of the list.
Because there are so few deceased donor kidneys available each month, it may take some time until your loved one receives a transplant. The chart below shows the number of deceased donor kidneys of a given blood type that become available in a typical month:
| Blood Type | Per Month |
| A | 8 |
| O | 7 |
| B | 3 |
| AB | 1 |
Because of the limited number of kidneys, the recipient may wait several months before a suitable kidney is available. If the recipient has a high level of antibodies, it may be more difficult to find a kidney. Ask your transplant doctor about the antibody level, which is checked using a test called the panel reactive antibody (PRA). The chart below shows the chances of a compatible kidney being found based on the PRA.
| PRA Level | Donor Kidney |
| PRA < 10 percent | 98 percent |
| PRA 10 - 19 percent | 47 percent |
| PRA 20 - 29 percent | 31 percent |
| PRA 30 - 39 percent | 19 percent |
| PRA 40 - 49 percent | 19 percent |
| PRA 50 - 59 percent | 14 percent |
| PRA 60 - 69 percent | 11 percent |
| PRA 70 - 79 percent | 11 percent |
| PRA > 80 percent | 5 percent |
If a patient has a PRA level that's greater or equal to 80 percent, only one kidney in 20 (or 5 percent) would be a match. Even if one has a high PRA, this program will help because being high on the waiting list will make it more likely a matched kidney will be found.
We will do everything possible to find a good deceased donor kidney for the recipient. Live donor kidneys, however, are generally better than most deceased donor kidneys.
Who Can Participate
Any donor and recipient pair who has incompatible blood or antibodies can participate in this program after discussing the program with the transplant doctor and signing the consent forms. Copies of the donor and recipient consent forms are available on this Web site. If the testing shows that either the donor or the recipient is not a candidate for surgery, they will not be eligible to participate.
For more information and to receive a copy of the consent form, contact a transplant coordinator at (415) 353-1551.
Consent Forms:
The consent forms linked to from this page are in Portable Document Format (PDF). These documents can be viewed using Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, you can download it for free from Adobe's Web site.
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