Types of Kidney Donation

There are four types of living kidney donation: direct donation, paired exchange donation, Good Samaritan donation, and advanced donation.

Direct Donation

With direct donation, the donor generally knows the recipient and donates directly to them.

If the donor is compatible, the donor’s kidney can be transplanted directly into the recipient. One problem with direct donation is that direct donors are often incompatible or poorly compatible with their intended recipients – this means they are not the right blood type or do not pass a cross match test with the intended recipient.

However, a donor can still help their intended recipient get a transplant if they are incompatible by participating in a paired exchange.

In order to donate a kidney in a direct donation, donors must:

• Be healthy
• Be blood compatible
• Pass cross match

Paired Exchange Donation

In a paired exchange, a donor will donate their kidney to another recipient in exchange for a compatible kidney for their loved one.

In the example to the right, the first pair, a mother and her son are incompatible. The second pair, a husband and his wife are also incompatible. In this exchange, the mother donates to the wife of the second pair and the husband donates to the son in the first pair.

Often compatible pairs enter into a paired exchange to get a better matched donor.

Advanced Donation Program

The Advanced Donation Program (ADP) is a kidney paired exchange separated in time.

There are two types of ADP cases:

• Short-term cases, where the intended recipient is on dialysis or is in imminent need of a kidney transplant
• Voucher cases, where the intended recipient is currently not in need of a kidney transplant and may never need a transplant.

Both types of ADP cases allow donors to donate their kidney before their intended recipient receives a kidney. Some ADP donors have donated just a few months before their intended recipient was transplanted (short term cases).

Some ADP donors have donated 20+ years before their intended recipient is expected to need a transplant (voucher cases) with the hope that their intended recipient will never need a transplant.

Good Samaritan Donation

With Good Samaritan donation, the donor is giving to a stranger which initiates a chain of transplants. Chains are a way for one Good Samaritan donor (aka non-directed donor) to help many patients get transplanted.

Chains are also revolutionizing the paired exchange process by facilitating better donor-recipient matches including some six antigen matches, which is important because a great match allows the transplanted kidney to last longer.

Many Good Samaritan donors choose to start chains because it is a way to help more than one person suffering from kidney failure. One chain typically facilitates anywhere from 2 to 30 transplants.