Kidney Compatibility: Finding the Best Match

When you need a kidney transplant, finding the best match can mean a more successful transplant. The better the match between the donor and recipient, the longer the transplanted kidney can last.

How Does the NKR Find the Best Donor-Recipient Match for Kidney Transplants?

Traditionally, kidney transplant matches were measured by an HLA match score from zero to six, with six being the best. HLA scores are generally based on A, B and DR antigens. An antigen mismatch is where rejection often starts.

Behind antigens are eplets, which are essential components of HLA epitopes recognized by antibodies. Eplet mismatch analysis has been proven to be a more precise measure of a donor-recipient match compared to antigen matching.

By minimizing eplet mismatches, a transplant recipient can potentially:

  • Reduce the risk of de novo DSA formation
  • Lower the probability of rejection
  • Lower the probability of graft failure
  • Lower their immune-suppression dosage

The National Kidney Registry can help you find a better-matched living donor kidney. Transplants facilitated through the NKR have a lower failure rate at three, five and seven years post-transplant.

Why Compatible Pairs Can Benefit from Using the NKR

Paired exchange—when a donor donates their kidney to another recipient in exchange for a compatible, or better-matched, kidney for their loved one—was originally created to overcome cases of donor-recipient incompatibility, when the donor could not give directly to the intended recipient.

However, compatible pairs—donor-recipient pairs where the donor can donate directly to the patient—can also greatly benefit from entering paired exchange.

Through paired exchange and the Kidney for Life initiative—which utilizes the latest generation in DNA sequencing technology to assess the histologic match between patients and donors—compatible pairs can find excellent matches, and the recipient can potentially reduce their immuno-suppression dosage and have a transplanted kidney that lasts longer.