Introduction Kidney paired donation (KPD) is critically dependent on the availability of a large number of willing and acceptable donors. Accepting a large number of potential donors (PoD) to the pool increases the chances of finding a match but increases the resources used to screen and evaluate PoDs. The aim of the study was to determine if a KPD program lead to increasing PoDs for each recipient when compared to conventional living donor kidney transplant (LDKTx).

Methods: We examined all transplants performed through our participation in a multi-site KPD program between September 2007 and October 2012. PoDs were defined as those persons who returned a mailed out kit for blood group and HLA testing. In the KPD program, our intent was to be more inclusive than restrictive. PoDs that resulted in possible KPD chains based on these criteria underwent a full medical, surgical and psychosocial evaluation. The control group consisted of conventional transplants performed during the same period.

Results: 538 patients underwent conventional LDKTx and 1526 PoDs were screened for blood group and HLA. 73 patients underwent a kidney transplant as part of the KPD program and 277 PoDs were screened for blood group and HLA. The average age of the donor for a conventional LDKTx was 46 years old (range18-72) and 47 years old (range 18-69) in the KPD program (p=0.82). The table below shows that compared to conventional LDKTx, KPD had: 1) a higher number of PoD screened/tested; 2) a higher rate of turndowns; and 3) a longer time between initial contact and transplantation.

Conclusion: In this series, KPD led to more PoDs per recipient, more turn downs, and a longer time from first contact to donation. These data highlight the importance of developing new donor evaluation procedures to improve the “efficiency” while maximizing the number of acceptable donors.

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