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Kidney Patients - National Kidney Registry - Facilitating Living Donor Transplants   Skip navigation
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Kidney Patients


There are over 150,000 people in the United States living full and active lives with transplanted kidneys. Kidney transplants are truly a miracle of modern medicine. If you are facing kidney failure and are medically qualified for a transplant, we want you to have the miracle of a kidney transplant. We have even written a book for you called "Finding a Kidney" that will help you navigate this complex process. You can download the book by clicking HERE or you can buy it on The National Kidney Registry is committed to helping you get a transplant - If you have an incompatible donor or a poorly matched donor -you have come to the right place. We can help you.

Patient Benefits

Dialysis vs. Transplant

People facing kidney failure who are medically qualified for transplant surgery have two basic options: stay on dialysis or get a transplant. Transplantation is far superior to long-term dialysis on all fronts. Transplant patients generally live twice as long as those who stay on dialysis and transplant patients are not restricted by the challenging routine of dialysis therapy. These factors and the quality of life improvements lead many people to seek transplants.

Deceased Donor vs. Living Donor Transplants

In pursuing a transplant, there are two options: a deceased donor transplant or a living donor transplant. Kidneys transplanted from living donors are superior because they last nearly twice as long as kidneys transplanted from deceased donors.

Time Matters

Once a person has made the decision to get a transplant, time matters. Studies indicate that the less time the patient is on dialysis, the better the transplant outcome. Receiving a preemptive transplant and never going on dialysis leads to higher transplant success rates.

Living Donor Kidneys Last Longer
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Ten year overall adjusted graft survival - Pre-emptive Living Donor Transplant vs. Dialysis
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The Match Matters

Not only does time matter but the donor - recipient match matters too. The most significant matching variable that can be improved via paired exchange is the HLA match. The donor age is less significant but can also be improved via paired exchange. Below are charts that show the impact of the HLA match and donor age on transplant outcomes.

Antigen Match Between Donor and Recipient Matters
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Donor Age Matters
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Why the National Kidney Registry

The NKR provides patients the best chance of safely finding a well matched donor which increases graft survival and is correlated with more kidney life years. The NKR works with all the top transplant hospitals in the United States and has facilitated more exchange transplants than any other exchange program in the world. Additionally, the patient outcomes from transplants facilitated by the NKR exceed the average U.S. living donor transplant outcomes. We believe this is driven by the improved donor - recipient matches available through the NKR which is the largest living donor pool in the world.

There are some transplant centers that attempt to provide paired exchange services from a "single center." This approach may make the logistics easier (no need to ship kidneys or coordinate surgery dates with other centers) but this "single center" approach cannot equal the NKR's ability to improve HLA and donor age matching. This is because paired exchange is inherently a numbers game and the NKR operates the largest paired exchange program in the world and has the largest pool of available donors. Additionally, single center programs have limited ability to "repair" a real-time swap failure (e.g. recipient experiences complications during surgery and cannot receive the kidney). If a single center program cannot "repair" a failed swap, the patient, whose paired donor has already donated, is left without a kidney. If you are considering using a single center swap program, ask them how they prioritize patients in the event of a real-time swap failure where the patient is left without a kidney. The NKR has successfully resolved many of these real-time swap failures and the NKR solution for resolving real-time swap failures is outlined in our Medical Board Policies.

Graft Survival - NKR Transplants vs. U.S. Living Donor Transplants as of 3/19/2014
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Patients enrolled with the NKR will:

  • Increase the chance of a "clean cross-match" eliminating the need for desensitization.
  • Reduce the chance of not getting a match or waiting a long time for a match.
  • Increase the chance of finding a great HLA match which is correlated with more kidney life years.
  • Increase the chance of finding an age compatible donor match which is correlated with more kidney life years.
  • Minimize the risk of a real-time swap failure where the patient could be left without a kidney.


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Patients without Living Donors

The CHIP program helps patients without donors who are either children or are disadvantaged because they are sensitized. Member centers that evaluate Good Samaritan donors and start have the ability to end chains at their centers and get patients transplanted who do not have a living donor. Below is the CHIP program description.

  • NKR member centers that have net chains started > 0 may enroll up to 50 candidates in the CHIP program
  • Net chains started is the total number of chains that a center starts less the total number of chains a center ends
  • CHIP candidates must be children (18 or younger) or sensitized adults
  • The most likely blood types to find a CHIP match are "AB" and "A" blood types
  • The CHIP program is used as a last resort. The probability of a match dramatically improves when a paired donor(s) are available


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Next Steps

Click here to review a list of Kidney Transplant Centers.



Help for Medicaid/MediCal Patients 

Medicaid and MediCal patients are typically disadvantaged in paired exchange because these insurance programs will generally not pay for out of state physician's fees which will block matches with out of state donors. The best opportunity for Medicaid/MediCal patients is to convert their insurance to Medicare. NKR Member Center should be able to assist patients with the conversion to Medicare.


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