Types of Living Donation

There are different types of living donation, which generally are determined by two factors--(1) whether the donor and recipient are biologically related and (2) whether the donor is directing the donation. "Directing" means the donor identifies the specific person to whom he or she is donating. The different forms of donation and the terminology used to describe them are as follows:

·                     Living related donation: the living donor directs the donation to a specific recipient who is a blood relative (such as a parent, child, or sibling). Looking at UNOS data for living kidney donations made since 1988, about 75% were living related donations.

·                     Living unrelated donation: the living donor directs the donation to a specific recipient who is not a blood relative (such as a spouse, a friend, or co-worker). About 24% of living kidney donations since 1988 were living unrelated donations.

·                     Living non-directed donation: the living donor does not direct the donation. Instead, the recipient is selected from a list of compatible people on a kidney waiting list. This form of donation is also sometimes called "anonymous" donation because the donor and recipient do not necessarily ever meet. Only about 1% of living kidney donations are of this type.

Another type of living donation is called paired exchange. In this situation, there are at least two donor/recipient pairs where the donors are not able to donate to the directed recipients because of blood types that aren't compatible or because of a positive crossmatch. (See LDO kidney page 4 for more on blood and tissue compatibility.) 

However, the donor in one pair is compatible with the recipient of the other pair, and vice versa, allowing the donor of one pair to donate to the recipient of the other pair.  In some cases, more than two donor/recipient pairs are linked in an extended "chain" of donation.

Here's an example of a paired exchange. Assume in the first donor/recipient pair, the donor, Jim, is blood type A and the person he'd like to donate to, Lisa, is blood type B. Jim can't donate to Lisa because they have incompatible blood types. In the second pair, the donor, Niki, is blood type B and she'd like to donate to Mike, but he's blood type A. They are incompatible. Paired exchange provides the solution: Jim donates to Mike (both blood type A), and Niki donates to Lisa (both blood type B). This form of living donation is rare, but organizations have been formed recently to facilitate the matching of donor/recipient pairs. As a result, the number of paired exchanges is increasing rapidly. 

More information on the paired exchange organizations can be found on the LDO kidney links page.

http://www.livingdonorsonline.org