Advantages of Paired Donation
• Deceases time on deceased donor organ wait list
• Decreases time on dialysis
• Decreases healthcare costs significantly
• Increases healthy organ procurement
• Increases short and long-term
success rates
Today, there are over 70,0001 people on the kidney transplant list waiting
for a deceased donor organ. The average wait time for a kidney is three to six years
depending upon blood type, region and other factors. Many of these transplant
candidates will die before they receive an organ, and the transplant list continues to
grow at an alarming rate-- almost 10% annually for the past decade.2 The financial
resources required to care for these patients places an enormous burden on
an already overtaxed medical system. Additionally, the longer a transplant
candidate remains on the list, the longer they remain on dialysis, which significantly
increases the likelihood of developing morbid disorders associated with prolonged
dialysis and raises the cost of care astronomically for each patient.
Paired
donation is an innovative approach that utilizes healthy, living donor organs
when the intended recipient is incompatible with his or her donor. The
basic process is to match two incompatible donor/recipient pairs with an alternate
compatible pair.
By increasing the availability of viable living donor organs, more people
can be transplanted, lessening the impact on the deceased donor organ waiting list
and allowing end stage renal disease patients the opportunity to have a living
donor from a less restrictive pool of organs. Additionally, research shows that living donor
kidneys are preferable to deceased donor kidneys. The latest five-year graft
survival rate for deceased donor kidney transplants is 66.7%, while the rate for living
donor transplants is 80.2%.3
The notion of paired donation has been
pioneered at a number of institutions, most notably the Johns Hopkins University
Incompatible Kidney Transplant Program, who performed the first paired donation
kidney transplant in the United States in 2001. However, despite all its obvious and important advantages, relatively
few paired donations have been performed nationally.4
The biggest hurdle to paired donation is the painstaking process of combing through all the recipient/donor data
and finding a match. This requires the ability to analyze in real time a potential
incompatible donor pair with all other pairs in the pool in real time while evaluatiing
their blood types, antigen avoids, age differentials and more. When one multiplies
the time and cost required to complete this analysis for every incompatible
pair on the list, it‘s no surprise why so few successful paired donation
transplants have occurred.
Silverstone Solutions has developed a solution for
this problem, Matchmaker, a clinical application designed with advice from
leading nephrologists, that utilizes a suite of custom algorithms to generate
paired donation matches for an entire pool of potential recipients. Matchmaker
can perform the difficult task of co-matching two interested donor/recipient
pairs from a selectable pool of alternative donor-recipient pairs. It also
evaluates key immunologic parameters including blood type, 14 specific antigens,
age and degree of compatibility with other donor-recipient pairs on the list.
Finally, it optimizes the pairings to yield the greatest number of transplants for
a given pool. Matchmaker
can provide results in minutes that would not be possible by hand. Matchmaker
is also a robust and flexible tool that allows nephrologists and transplant
clinics to directly manipulate the pairs to their exact requirements. Triple
swaps are also readily analyzed. For more information about our products, please
review our Product
Overview page.
1. Source: United Network for Organ Sharing, January
2007
2. Source: OPTN/SRTR as of May 2, 2005
3. Source:
2005 OPTN/SRTR Annual
Report, Table 1.13.
4. As of
April 25, 2005 – Johns Hopkins transplanted 51 patients via
paired donor exchanges, the most of any organization in the country.