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Kidney-paired donation: benefits and challenges
Darshana M Dadhania1, Dinesh Kannabhiran1, David Serur2
1Division of Nephrology, Weill Cornell Medicine - New York Presbyterian Hospital, New York City, New York.
Current Opinion in Organ Transplantation
|April 4, 2026
Summary
Kidney-paired donation (KPD) improves living-donor kidney transplants but faces challenges. A national KPD program could enhance access and equity for patients with kidney failure.
Area of Science:
- Nephrology
- Transplantation immunology
- Public health
Background:
- Living-donor kidney transplantation offers superior outcomes for kidney failure patients.
- Access to living-donor kidney transplantation is hindered by various barriers.
Purpose of the Study:
- To review recent advancements in kidney-paired donation (KPD).
- To identify current challenges and future directions for KPD programs.
- To optimize KPD program performance and equity.
Main Methods:
- Review of recent developments in kidney-paired donation.
- Analysis of current challenges and future directions.
Main Results:
- KPD programs have expanded globally, showing excellent patient and allograft outcomes.
- Altruistic donors, advanced donation models, and HLA-matching have improved compatibility.
- Challenges include donor-recipient imbalances (e.g., Blood Group O), uneven participation, financial/logistical hurdles, and ethical considerations.
Conclusions:
- A national, accessible KPD program is crucial for increasing living-donor kidney transplantation opportunities.
- Incorporating compatible recipient-donor pairs into a national program will enhance transplantation access.
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