Since January 2009, hundreds of living donors across Canada have shared the gift of life through the national Kidney Paired Donation program, including many non-directed (not directed towards a friend or family member) anonymous donors.
There are 25 Living Kidney Donation and Transplant Programs involved in the Kidney Paired Donation program across Canada.
Non-directed anonymous donors are responsible for more than two-thirds of the transplants in the Kidney Paired Donation program.
In the KPD program to date, all patients with a match have received a transplant in less than a year.
Before the KPD program, patients could wait for many years before receiving a transplant.
Today, the country is working as a whole to find more matches for more patients. Patients have access to a larger pool of donors and each case is given individual attention from the Kidney Transplant Advisory Committee – a national community of experts – until it is closed.
Paired exchange is an established practice throughout the world.
The participation of all donors and recipients in the Canadian Transplant Registry is completely voluntary. All participants involved are free to withdraw at any time before the donor operations take place.
Kidney Paired Donation significantly reduces the time it takes to go to transplant, if a medically suitable match can be found. In comparison, patients on the deceased donation list wait, on average, four to five years.
Any adult who is in general good health can be assessed to become a living kidney donor. If the donor wishes to donate to a friend or family member, medical assessments are conducted to determine whether the donor is a suitable match for the recipient. With a compatible match, the donation can proceed with the provincial program independently, and the KPD program is not used.
If the donor is not a match for their friend or family member, they may be able to donate through the KPD program.
Why it is important
Unfortunately, there are not enough deceased kidney donations to help everyone who needs a kidney transplant. Patients on the deceased donation wait list can wait, on average, for four or five years and some will never receive a kidney transplant.
How it works
Once the provincial transplant program assesses and qualifies the donor as eligible to donate, the donor must consent to be considered for donation and agree to being listed. Only then does the provincial program enter the donor’s medical information into the Canadian Transplant Registry, a secure computer database managed by Canadian Blood Services. The donor and their specific friend or family member who requires a kidney transplant are “paired.”
When an individual donor enters the program to give anonymously they must be assessed for donation and cleared to enter the KPD donor pool as a non-directed donor (those who do not have a specific friend or family member to pair with but who wish to donate). All donors are given the choice to proceed or withdraw from the process at any time and those wishes are always honoured.
A sophisticated matching program is run against all the pairs including non-directed donors in the registry, to identify potential donor matches that can form pairings or “chains” of donor kidney exchanges. The matching program seeks to match the recipients with a kidney donor for a transplant.
Canadian Blood Services provides the patient listing and matching program that serves transplant programs in Canada.
Medical evaluations of patients and all communication with the donor or recipient is conducted directly by the provincial programs supporting the individuals in the pair, respecting the anonymity and privacy of all those involved.
Once matched in a chain, further assessment is required of the donor and recipient. If a donor or recipient cannot continue to proceed for any reason, the pairings or chains must be re-evaluated. Depending on the circumstances, some or all of the pairings or chains may not proceed to transplant and the donors and recipients may continue to await another matching cycle.
Even when matched, there is no guarantee that the match will lead to a transplant, as issues can occur with any participant in the chain. If a patient’s paired donor donates and the matched recipient does not receive a transplant, the KPD program makes it a priority to continue to search for another match for the patient until a suitable donor can be found.
The Kidney Paired Donation program recognizes the process can be a stressful one for all involved. Each case is taken very seriously and every effort is made to find a match as quickly as possible for all registered recipients.
The national Kidney Paired Donation (KPD) program is operated by Canadian Blood Services in partnership with Canada’s provincial living kidney donation and transplant programs to give living donors another way to help patients receive a kidney transplant.
Canadian Blood Services
Donor provincial program
Recipient provincial program
Manages the Canadian Transplant Registry for listing and matching living kidney donors with patients in need of a kidney transplant. Matches pairs.
The donor’s local living kidney donation program does all medical evaluations and communicates with the donor.
The recipient’s local transplant program does all medical evaluations and communicates with the recipient.
Plays a coordinating role by facilitating communication between the living kidney donation and transplant programs across the country to keep the evaluations of the matched donors and recipients in the chains moving forward as quickly as possible.
Communicates with the donor regarding his/her status and the progress of the chain of transplants.
Communicates with the recipient regarding his/her status and the progress of the chain of transplants.
In collaboration with the national Kidney Transplant Advisory Committee (which is made up of leading experts in the field from all provincial programs), reviews the progress of all the chains monthly, to ensure continued progress of the chains and that high priority cases receive appropriate attention and follow-up.