In order to utilize a willing but incompatible living donor, candidates must either proceed with incompatible transplantation or find a more compatible match using kidney paired donation (KPD). A criticism of KPD is that the "easy-to-match" candidates leave the registry quickly, and thus concentrate the pool with sensitized candidates, making future matches challenging.

Methods: We studied 2503 registrants to the National Kidney Registry (NKR), the largest KPD clearinghouse in the US, from 2011-2016. Both the incident and prevalent pool of candidates were studied over time.

Results: Candidates had a median age of 50 (IQR 39-60) years, were 51.2% male, 65.7% white, and had a median BMI of 27 (23-31). Overall, 58.5% had blood type O, 24.9% type A, 14.3% type B, and 2.2% had type AB. Overall, 29.6% had PRA 0, 29.8% 1-79, 17.7% 80-97, and 22.9% had PRA 98% or higher. There were no changes in the prevalent pool of candidates awaiting KPD (Figure 1), except an initial increase in candidates with PRA≥80% (28.0% in 2011 to 41.1% in 2012, Figure 2). Importantly there were also no changes in the rate of deceased donor kidney transplant over this time period.

Conclusion: In this large, national KPD clearinghouse, there is no evidence that candidates have become more “hard-to-match." Providers should continue to counsel candidates who are not sensitized and their potential donors to consider KPD.

Figure 1. Candidate Blood Type in NKR Pool by Year.

Figure 2. Candidate PRA Categories in NKR Pool by Year.

CITATION INFORMATION: Holscher C., Jackson K., Thomas A., Haugen C., DiBrito S., Ronin M., Waterman A., Massie A., Garonzik Wang J., Segev D. Temporal Changes in the Characteristics and Sensitization of Kidney Paired Donation Registrants Am J Transplant. 2017;17 (suppl 3).

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