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Kidney Donor Exchange Program

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 TypePer Month

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 LevelDonor Kidney
PRA < 10 percent98 percent
PRA 10 – 19 percent47 percent
PRA 20 – 29 percent31 percent
PRA 30 – 39 percent19 percent
PRA 40 – 49 percent19 percent
PRA 50 – 59 percent14 percent
PRA 60 – 69 percent11 percent
PRA 70 – 79 percent11 percent
PRA > 80 percent5 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 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.

Related Information

How to Reach Us

Connie Frank Transplant Clinic
400 Parnassus Ave., Third Floor
San Francisco, CA 94143
Phone: (415) 353-1551 or (888) 894-6361
Fax: (415) 353-8708

Consent Forms

Donor Consent Form
Recipient Consent Form

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