Kidney Paired Donation (KPD) Program

The national Kidney Paired Donation (KPD) program is an interprovincial program operated by Canadian Blood Services in collaboration with Canada’s living kidney donation and kidney transplant programs. The KPD program gives individuals an opportunity to become a living donor and donate a kidney to someone in need, and in doing so, provide transplant candidates an increased opportunity to receive a transplant.

 

Any adult who is in general good health can be assessed to become a living kidney donor. Before the donation, the person is a potential donor. Someone who needs a kidney transplant is a transplant candidate. Every potential donor undergoes a thorough medical assessment by a Living Donation Program to ensure they are healthy enough to donate one of their kidneys.

Directed Donation: A potential donor can be assessed to donate to someone they know such as a family member or friend. If tests determine they are a medically compatible match, the donation and transplant can proceed. This is a directed donation. If they are not medically compatible, the potential donor may still be able to help the transplant candidate find a matching donor by enrolling with them in the KPD program as a registered pair.

Non-directed Donation: If a potential donor does not know someone who needs a kidney transplant and wants to donate to someone in need, they are known as a Non-Directed Anonymous Donor (NDAD). NDADs can enroll in the KPD program by themselves to help others receive kidney transplants.

 

The Living Donation Programs and Kidney Transplant Programs across Canada register the NDADs, potential donors and transplant candidates into the Canadian Transplant Registry. The CTR is a secure computer database managed by Canadian Blood Services. The CTR’s sophisticated matching algorithms identify potentially medically suitable matches of transplant candidates with potential donors and NDADs. The matches are grouped into ‘chains’ of donor exchanges so that each transplant candidate in the chain receives a suitably matched kidney transplant.

 

KPD Registered Candidates, Transplant Recipients, and NDADs by PHN Province 

The Kidney Paired Donation program is completely voluntary. All potential donors, NDADs and transplant candidates have the choice to proceed or withdraw from the process at any time.

Learn more about how it works

Approximately three times a year, Canadian Blood Services runs the matching algorithm in the Canadian Transplant Registry. The algorithm compares the medical information of all the pairs and NDADs and identifies chains of potential kidney transplant opportunities. Once potential exchanges/ chains are identified, medical teams must determine if it is possible to complete all the matches in the chain before the transplants/ donations can proceed.

There are three types of KPD chain exchanges:

1) Paired Exchange
In a paired exchange, Donor A wishes to donate a kidney to transplant Candidate A, but they are not a match. Donor B would like to donate a kidney to transplant Candidate B, but they are not a match.  However, Donor A is a match with transplant Candidate B and Donor B is a match with transplant Candidate A. A paired exchange is then completed.

The information and images in these materials may be used with inclusion of a source credit to Canadian Blood Services. For more information, consult creative commons © 2018 Canadian Blood Services. 

2) N-Way Exchange or Closed Chain
An n-way exchange, or closed chain, is similar to a paired exchange, except there are more pairs included and the donor of the last pair donates to the transplant candidate of the first pair.

The information and images in these materials may be used with inclusion of a source credit to Canadian Blood Services. For more information, consult creative commons © 2018 Canadian Blood Services. 

3) Domino Exchange or Domino Chain
Domino exchanges begin with a non-directed anonymous donor (NDAD) who donates to the transplant candidate of a registered pair. There can be multiple registered pairs in a domino exchange as you can see below with pairs A, B and C.
The exchange is complete when the donor of the last registered pair donates to a transplant candidate on a transplant waitlist.

The information and images in these materials may be used with inclusion of a source credit to Canadian Blood Services. For more information, consult creative commons © 2018 Canadian Blood Services. 

Paired Exchange, Closed Chain, Domino Exchange - A Short Presentation*

Download this presentation in animated powerpoint format*

The information and images in these materials may be used with inclusion of a source credit to Canadian Blood Services. For more information, consult creative commons © 2018 Canadian Blood Services. 

Power of one—the non-directed anonymous donor (NDAD)

NDADs are very important to the success of the KPD Program. When a non-directed donor — a person who is not paired with a transplant candidate, yet wishes to donate a kidney to someone in need — enrolls in the KPD program, their kidney donation is not conditional on a friend or family member receiving a transplant in return. This allows the KPD program to identify chains of exchanges that create significant numbers of transplant possibilities that otherwise would not be possible.

Non-directed donors greatly increase the number of matches that can be made among the registered pairs in the CTR.

Since they enter as a single rather than a pair, it also means that at the end of the domino exchange, one patient on the deceased donor waiting list also receives a kidney transplant.

For a list of all Canadian living kidney donation programs, please click here.

Brochures

For more information about living kidney donation, download the following brochures:

What is Living Kidney Paired Donation
Kidney Paired Donation (KPD) Program

Requests for brochures can be made by calling our Customer Support team at 1-855-274-2889 or by emailing transplantregistry@blood.ca