Directed Donation, Paired Donation and Donor Chains
Most people have two kidneys, though healthy people can live normally with only one functioning kidney. In a living donor kidney transplant, a healthy individual who is willing to undergo surgery to donate a kidney has one of their healthy kidneys removed so it can be transplanted (grafted) into a recipient.
There are three types of living kidney donations.
Direct kidney donors are usually family members, long-standing friends, or members of the same religious congregation, who are in excellent health and between the ages of 18 and 70. They typically have a strong existing emotional connection with their intended recipient. These donors are considered directed donors, because they direct where their donated kidney will go. (As a result of advances in transplant medications, direct donors do not have to be biologically related to the recipient.)
In some cases, a directed donor’s blood or tissue type is incompatible with their intended recipient. Special medicines can sometimes overcome these barriers. Where the barriers cannot be overcome, these donor-recipient pairs may pursue a paired donation, in which the living donor and chosen recipient are matched through the national organ transplant databases with a compatible donor-recipient pair, and the donations and transplants happen in tandem.
In rare cases, more than two compatible and willing donor-recipient pairs form a kidney donation chain.
In December 2009, Scripps was the first in San Diego to perform a three-paired kidney exchange between six people, and recently participated in the first international kidney exchange chain.
Known recipient donors
Some people have only recently met the person to whom they wish to donate a kidney. Their reason for donating must be the same as the first two groups –altruism (the desire to do something good for another person).
The buying and selling of organs is illegal in the United States; kidneys may not be donated in return for financial gain of any kind. The transplant team at Scripps can help altruistic donors fulfill their wish to give an organ, at the same time taking great care to ensure that a number of important conditions are met beforehand.
- The donor and recipient must meet face-to-face early in the process of donor evaluation.
- Both the donor and recipient will be required to undergo psychological testing to ensure their motives and the lack of any evidence of coercion.
- Finally, both the donor and recipient must sign a contract affirming no money will be exchanged as a result of the donation.
Altruistic, anonymous or “non-directed” donors wish to donate a kidney to someone in need, but do not personally know someone who is waiting for an organ. Kidneys from these donors go to the patients at the top of the waiting list at Scripps.