Introduction: Compatible pairs of living kidney donors and their intended recipients are being increasingly entered into living donor kidney transplant (LDKT) exchanges. The characteristics of these compatible pairs have not been well described.

Methods: We examined the records at our center of 9 recipients of living donor kidney transplants, their 9 compatible (also known as original or intended) living donors, and their 9 “actual” living donors, whose transplants/donation occurred from 2012-2015.

Results: The 9 recipients received LDKTs as part of 8 different chains that included 24 total LDKTs (15 additional LDKTs). The 9 recipients were all male and 67% White, with a mean age of 55.5 (SD 15.2) years. 4 (44%) were college graduates. 8 of 9 (89%) recipients had PRA of 5% or less. Of the 9 intended ("original") living donors, 4 (44%) were the spouse of the intended recipient, all 9 were female and blood group O, 5 (56%) were college graduates, and their mean age was 56.6 (SD 6.7). The primary reasons why the compatible donor-recipient pairs participated in paired exchange were the age difference between the recipient and intended donor (N=6), body or kidney size difference between the recipient and intended donor (N=2), and desire to help other recipients (N=1). Desire for better HLA matching was not the primary reason for participation for any pairs. In the 6 cases of age difference, the intended donors were a median of 3.3 years younger than the recipients (25-75% range, 11.9 years older to 4.5 years younger), while the actual donors were a median of 17.5 years younger than the recipients (25-75% range, 4.5-20.6 years younger). In the 2 cases of size difference, one recipient received a LDKT from a donor who was 60 pounds larger than the intended donor, and the other recipient received a LDKT from a donor whose calculated donor kidney volume was 78 mL greater than the volume of the intended donor's kidney. Internal (i.e. solely at our center) exchanges (N=6) vs. external (i.e. multicenter) exchanges (N=3) using compatible pairs had similar times from the initial recipient evaluation to transplant (555 vs. 616 days, P=0.80) and from intended donor's initial referral to donation (345 vs. 229 days, P=0.44).

Conclusions: Most compatible donor-recipient pairs entered into LDKT exchanges so that the recipient could receive a transplant from a donor whose age or body/kidney size were more favorable to post-transplant outcomes.

CITATION INFORMATION: Weng F, Grogan T, Patel A, Mulgaonkar S, Morgievich M. Characteristics of Compatible Pair Participants in Living Donor Kidney Transplant Exchanges. Am J Transplant. 2016;16 (suppl 3).

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