Living donor pool/incompatible transplants
Ideally the donor and recipient should ‘match’ as closely as possible in two areas – the blood group and the tissue type. Until a few years ago if the donor was not the right blood group or the recipient had antibodies to the donor’s tissue type there was no possibility that they could donate. Now however there are options.
Living donor pooled exchange programme
This is a sharing pool scheme for living donor kidneys where they are ‘swapped’. For example, if you (Mrs A) wanted to give a kidney to your sister ( Miss A) but you had the wrong blood group, it may be that your kidney will suit Mrs B in another part of the country and that Mr B (who couldn’t donate directly to his wife because of his blood group) has a kidney that would suit your sister, making it possible for two transplants to happen in this pooled exchange programme.
If a donor and recipient pair is entered into the pool then their details are registered with the national centre in England. Four times in the year (January, April, July and October) there is, what is known as, a ‘matching run’ when the computer programme looks at all the people who are registered and works out who would match whom (perhaps the ultimate online match!).
The pool exchange system: Mrs A cannot give her kidney to her daughter Miss A because she is the wrong blood group, and Mr B cannot give his kidney to his wife Mrs B because she has antibodies to his tissue type, but Mrs A’s kidney is a good match for Mrs B, and Mr B.
It is important to note that:
- The person giving the kidney, as well as the person getting, stays in at their nearest
- transplant centre and the kidneys are transported rather than the patients.
- The donor will not be giving a kidney unless there is a kidney coming for their friend/relative on the same day
- All the donors go to theatre at the same time, so there is no opportunity for one donor to change their mind.
The advantage of this scheme is that the patients will receive a good ‘straightforward’ live donor kidney without any antibody problems. The disadvantage is that there is no guarantee of getting a match.
If a donor and recipient have not been successful in getting matched in the live donor pool after three or four runs, any other options for transplantation will be discussed thoroughly with potential donors and patients by the consultant.