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Updated: Feb 14, 2026
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Published on: June 2, 2015
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Kidney exchange match rates in a large multicenter clearinghouse
Courtenay M Holscher1, Kyle Jackson1, Eric K H Chow1
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Summary
Kidney paired donation (KPD) wait times vary significantly based on blood type and antibody levels. Patients with high antibody levels or blood type O face longer waits for compatible kidney transplants.
Area of Science:
- Nephrology
- Transplantation immunology
- Biostatistics
Background:
- Kidney paired donation (KPD) offers a vital alternative for patients with incompatible living donors.
- Estimating KPD wait times is crucial for balancing transplant options against dialysis morbidity.
Purpose of the Study:
- To analyze factors influencing KPD wait times within the National Kidney Registry (NKR).
- To provide data for counseling patients on realistic KPD expectations.
Main Methods:
- Utilized a competing-risk framework on data from 1894 donor/candidate pairs in the NKR (October 2011-September 2015).
- Analyzed wait times based on donor/candidate ABO blood type and panel reactive antibody (PRA) levels.
Main Results:
- Median KPD wait times ranged from 2 months (ABO-A, PRA 0) to over a year (ABO-O or PRA 98+).
- High PRA levels (80-97% and 98%+) significantly reduced matching likelihood (23% and 83% less likely, respectively).
- ABO-O candidates had a 67% lower match likelihood than ABO-A candidates; ABO-B and ABO-O donors increased match likelihood compared to ABO-A donors.
Conclusions:
- KPD wait times are highly individualized, influenced by ABO blood type and PRA levels.
- Accurate patient counseling regarding KPD wait times and alternative options is essential.
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