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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

If you want to donate to someone in need of a kidney, the NKR will give you the best chance of helping the most patients with your gift. 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 NKR patient outcomes are superior to the average U.S. living donor transplant outcomes. We suspect these better outcomes are driven by the improved donor - patient matches available through the NKR program.

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 (10+ NKR patients have received 6 antigen matched kidneys)
  • Increase the chance of finding an age compatible donor match
Graft Survival - NKR Transplants vs. U.S. Living Donor Transplants as of 3/19/2014
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Single center exchange programs - CAUTION

There are some transplant centers in the United States that attempt to provide paired exchange services from a "single center". Although this approach will lower the Hospital’s cost and make the logistics easier (no need to ship kidneys or coordinate surgery dates with other centers) this "single center" approach can delay or even prevent a successful paired exchange transplant. Paired Exchange is inherently a numbers game - the larger the exchange program the greater the probability that the patient will be quickly matched and transplanted. Also, a large exchange program like the NKR facilitates better donor-recipient matches. These better matches will allow the transplanted kidney to last longer. The NKR is the largest paired exchange program in the world and provides the best chance for patients to find best match as quickly as possible.

Additionally the NKR has the policies in place and the volume to protect pairs in the remote event that your swap is impacted by a real time swap failure where a swap participant is left without a kidney (e.g. patient gets sick right before surgery). 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.


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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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