Introduction: The living donor kidney sharing scheme was introduced in the UK to expand the donor pool. In this study we have reviewed our experience since its inception in 2009.

Methods: Data were collected from a prospectively maintained database and review of case notes.

Results: 98 pairs have been registered since 2009. 24 pairs (24.5%) were successful to find a match. The mean age of the recipients was 57 y (SD±10) and 71% were female. The donors' mean age was 55 y (SD±12) and 46% were female. 79% of the donors were unrelated to the recipient, of which the majority were either spouse or partner. All donors from our centre had an uncomplicated laparoscopic donor nephrectomy.

22/24 (92%) of the successful pairs were equally split between blood group & HLA incompatibility. One donor was both HLA and blood group incompatible and in one pair the HLA match was poor.

13/24 (54%) of recipients found a match after a single matching run and 17/24 (71%) were matched after two runs. The mean number of runs per recipient is 2.5; two recipients required nine runs to match.

All patients received basiliximab induction with maintenance immunosuppression with tacrolimus and an antimetabolite. 20/24 (83%) patients experienced immediate graft function. Three patients had delayed graft function with early rejection confirmed on biopsy. One patient was re-explored for anuria on the same day and had a clot blocking the transplant ureter. The average length of inpatient stay was 7.5 days. All patients were discharged with a functioning graft and a mean creatinine of 116 (SD ±52).

Discussion: A quarter of our incompatible pairs have benefitted. The majority of pairs required two runs to match successfully. The outcome of the transplanted kidneys has been good. The scheme would benefit with more frequent matching runs and the inclusion of non-directed donors and pairs with a poor HLA match.

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