–The Paired Donation Process

For recipients and their donors to be eligible they must meet the following conditions: 

•–Each recipient must have at least one donor who is healthy.  Donors must be at least 18 years of age.

The recipient's donor must have the wrong  blood type or have a positive crossmatch test

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–Medical Evaluation and Tests for the Donor
  • History and physical exam
  • •Blood work:  blood count, tests for hepatitis and other viruses
  • Urine tests
  • • Chest x ray and electrocardiogram
  • •Pap smear in women over 40 years of age
  • Pregnancy test in women of childbearing age
  • Test for blood in the stool for all patients over 50 years of age
  • •PKD family history – renal ultrasound
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Medical Evaluation of the Recipient

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  • –The medical evaluation of the recipient is exactly the same as if the recipient were going to be listed for a deceased donor kidney.  This part of the usual transplant process is not changed for paired donation.  The recipient evaluation, however, must be complete before the recipient is registered in the paired donation program.Donor/Recipient Education
     
    Once the donor and recipient evalutations are complete, they will be asked to sign a consent to participate in the paired donation program.  At this time, the details of how the program works will be provided and all questions answered.
  • Donors and recipients are registered in the computer matching program after signing the consent form.

Computer Matching Process

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  • The usual time between computer match runs is two months.  However, depending on the number of patients registered, this time may be somewhat longer or shorter.
  • Once the computer match run is complete, doctors in the paired donation program will evaluate all potential matches to be sure that they are medically acceptable.
  • All matches that are found to be medically acceptable are then referred to the transplant centers for crossmatch testing.

Crossmatch Testing and Final Evaluations

  • Matched pairs undergo crossmatch testing (blood tests) by the transplant programs that will be performing the paired donation transplants.
  • If crossmatch tests are OK,  the transplant centers discuss the paired donation with donors and recipients and exchange information on donors and recipients.
  • Final consents are obtained from donors and recipients to proceed with the paired donation.

Final Preparations and Transplant Procedures

  • •A date for the transplants is selected
  • Each donor and recipient is asked if they wish to meet the others involved in the paired donation.
  • If all donors and recipients agree, a meeting is arranged.  If one donor or recipient does not wish to meet, no meeting is arranged.  
  • Travel arrangments for donors finalized
  • Donors travel to recipient hospitals
  • Both donors are put to sleep at the same time. 

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A Success Story: The Vollmars and the Meyers
Daniel Vollmar (second from the left in the picture) wanted to donate to his mother, Josephine (on the left in the picture), but Josephine developed immunity to Daniel's tissues when she was pregnant with him. Rose Meyer (on the right in the picture)  wanted to donate to her husband, Paul, but her blood type (blood type A) was not compatible with Paul's blood type (blood type O).  The Meyers were entered into the PDC web-based computer matching program by their transplant coordinator at the Christ Hospital in Cincinnati, and the Vollmars were entered by their  transplant coordinator at the Medical University of Ohio.

After they were matched by the computer, and  crossmatching testing was performed to assure sure that Daniel's kidney was compatible with Paul and that Rose's kidney was compatible with Josephine.   After these tests were completed, they met each other (see CNN story "A Vital Trade" below. 

A few weeks later, in a paired donation procedure, Rose donated her kidney to Josephine, and Daniel donated to Paul. Josephine would have likely waited three years or more for a kidney on the deceased donor wait list. Paul never had to go on dialysis, where he would have also waited for three or more years.  All four are doing well today, and have become close friends because of the extraordinary experience they had in the paired donation procedure.

 
Original PDC 30 centers
Great Plains PDC 5 centers
New Jersey PDC 6 centers
SouthEast PDC 15 centers
SouthWest PDC 22 centers
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