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International Kidney Paired Donation Programs : Evolution and Practices of 4 Large Collaborations

Klimentova, Xenia ; Domínguez-Gil, Beatriz ; Viana, Ana ; Manlove, David ; Andersson, Tommy LU ; Ashkenazi, Tamar ; Berlakovich, Gabriela ; Böhmig, Georg A. ; Burton, Jo and Coll, Elisabeth , et al. (2026) In Transplantation 110(6). p.1209-1219
Abstract

Kidney paired donation (KPD) programs are organized in various countries to facilitate the donation of kidneys from willing but incompatible donors by matching them with pairs in similar situations. These programs often struggle with an accumulation of difficult-to-match recipients and small pools of incompatible pairs. To address this, several international collaborations have emerged to expand the pool sizes and increase the number of transplants by “exchanging” donors’ kidneys across countries. We identified 4 established international KPD programs, each supported by protocols and agreements signed by the participating parties. Each program is presented separately, detailing its historical establishment, operational aspects, and... (More)

Kidney paired donation (KPD) programs are organized in various countries to facilitate the donation of kidneys from willing but incompatible donors by matching them with pairs in similar situations. These programs often struggle with an accumulation of difficult-to-match recipients and small pools of incompatible pairs. To address this, several international collaborations have emerged to expand the pool sizes and increase the number of transplants by “exchanging” donors’ kidneys across countries. We identified 4 established international KPD programs, each supported by protocols and agreements signed by the participating parties. Each program is presented separately, detailing its historical establishment, operational aspects, and statistics on pool characteristics and performance. Following this, we provide a comparative analysis of key aspects across the 4 programs. Each program has its unique context and specificities. Even though 3 of 4 collaborations started just before the COVID-19 pandemic, they have collectively facilitated >450 transplants. This underscores the importance of further developing these collaborations to share practices and experiences, and to facilitate more transplants, particularly for difficult-to-match recipients. Three of the 4 presented collaborations are either fully operated or led by European countries. This highlights the crucial role of ongoing international cooperation in the development of KPDs, in particular in Europe. By further promoting collaboration among countries, we can facilitate pan-European exchanges and improve access to live kidney transplants for patients in need.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Transplantation
volume
110
issue
6
pages
1209 - 1219
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:105030118896
  • pmid:41440830
ISSN
0041-1337
DOI
10.1097/TP.0000000000005602
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025
id
1a6effe4-0d32-4642-a93e-b7333d2eacf5
date added to LUP
2026-03-10 13:32:47
date last changed
2026-07-16 12:14:30
@article{1a6effe4-0d32-4642-a93e-b7333d2eacf5,
  abstract     = {{<p>Kidney paired donation (KPD) programs are organized in various countries to facilitate the donation of kidneys from willing but incompatible donors by matching them with pairs in similar situations. These programs often struggle with an accumulation of difficult-to-match recipients and small pools of incompatible pairs. To address this, several international collaborations have emerged to expand the pool sizes and increase the number of transplants by “exchanging” donors’ kidneys across countries. We identified 4 established international KPD programs, each supported by protocols and agreements signed by the participating parties. Each program is presented separately, detailing its historical establishment, operational aspects, and statistics on pool characteristics and performance. Following this, we provide a comparative analysis of key aspects across the 4 programs. Each program has its unique context and specificities. Even though 3 of 4 collaborations started just before the COVID-19 pandemic, they have collectively facilitated &gt;450 transplants. This underscores the importance of further developing these collaborations to share practices and experiences, and to facilitate more transplants, particularly for difficult-to-match recipients. Three of the 4 presented collaborations are either fully operated or led by European countries. This highlights the crucial role of ongoing international cooperation in the development of KPDs, in particular in Europe. By further promoting collaboration among countries, we can facilitate pan-European exchanges and improve access to live kidney transplants for patients in need.</p>}},
  author       = {{Klimentova, Xenia and Domínguez-Gil, Beatriz and Viana, Ana and Manlove, David and Andersson, Tommy and Ashkenazi, Tamar and Berlakovich, Gabriela and Böhmig, Georg A. and Burton, Jo and Coll, Elisabeth and Dittmer, Ian and Fiaschetti, Pamela and Fronek, Jiri and Hughes, Peter D. and Ivo da Silva, Margarida and Mor, Eytan and Viklický, Ondřej and Weinreich, Ilse Duus and Ferrari, Paolo}},
  issn         = {{0041-1337}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1209--1219}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Transplantation}},
  title        = {{International Kidney Paired Donation Programs : Evolution and Practices of 4 Large Collaborations}},
  url          = {{http://dx.doi.org/10.1097/TP.0000000000005602}},
  doi          = {{10.1097/TP.0000000000005602}},
  volume       = {{110}},
  year         = {{2026}},
}