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I have a living donor who doesn’t match, what can I do?

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Welcome to our question and answer page for kidney paired donation.

Below is commonly requested information about the Kidney Paired Donation Pilot Program (KPDPP). We hope you find it helpful.

If you have other questions or comments, contact the Organ Procurement and Transplantation Network (OPTN) Patient Services line at (888) 894-6361 or submit them here.

OPTN Kidney Paired Donation Pilot Program (KPDPP)

The KPDPP helps match people with kidney failure, but who do not have a living donor who matches them. In some cases, a person has someone willing to be a living donor, but they are not a match based on blood type or immune system typing.

For example, Mary wants to donate a kidney to Carlos, but they do not match. Amir wants to donate to Shauna, but they do not match. Mary is a match for Shauna, and Amir matches Carlos. Switching donors and recipients in this case allows both transplants to happen, with less risk that the recipient’s body will reject the donor’s kidney. This type of transplant is called kidney paired donation or KPD. KPD transplants can involve two or more recipient/donor pairs, resulting in more lives saved.

Mary wants to donate a kidney to Carlos, but they do not match. Amir wants to donate to Shauna, but they do not match. Mary is a match for Shauna, and Amir matches Carlos.

The KPDPP matches donors and candidates with other pairs who do not match. Your transplant team enters your medical information into a national database, managed by the OPTN. OPTN staff match pairs twice a week, then works with hospitals to plan the transplants.

Who can join?

Transplant candidates

If you need a kidney transplant, are getting care at a U.S. transplant hospital, and are on the organ transplant waitlist, you can join. You do not have to be on dialysis. You must have a living donor who is willing to donate a kidney, and the donor does not need to have your same blood type.


To be a donor, you must be at least 18 years old. You also must be willing to take part in a KPD transplant. All donors must complete medical and psychological testing before they can donate.

People who wish to donate a kidney to someone they don’t know are called non-directed, altruistic, or Good Samaritan donors. These donors enter the KPDPP alone, not as part of a pair. They may allow several transplants to happen.

What are the benefits of joining the KPDPP?


  • You could receive a living donor transplant.
  • You may spend less time on dialysis.
  • You may receive a transplant before starting dialysis.
  • You may not have to wait as long for a transplant.


  • Your loved one may receive a living donor kidney transplant.
  • Your donation can help other patients and their families.

As with any surgery, kidney donation and transplant involve risks. Discuss these risks with your transplant team.

Is there a fee to join the program?

No, there is no cost to join. Discuss the costs of donation and transplant with your transplant team.

What happens when a match is found?

The transplant team will contact transplant candidates and donors. Tests are arranged to confirm a good match.

Where would the transplant take place?


The transplant will take place at the hospital where you currently receive care. You can choose to travel to your matched donor’s hospital, if the donor is unable to travel and the kidney cannot be shipped.

Kidneys, if carefully preserved, can be shipped across a wide area of the country. They are usually transplanted within 36 hours after removal from the donor.


There are two options:

  • You can have your surgery at the hospital that entered you into the KPDPP. Your kidney will be shipped to your matched candidate.
  • You could travel to your matched candidate’s hospital for surgery.

What will happen to my status on the deceased donor waitlist?


If you join the KPDPP, you will remain on the waiting list. You will continue to receive deceased donor kidney offers. Participation in the program does not affect your wait-time or status on the deceased donor list.

Can donors and recipients meet?

Yes, after surgery, donors and recipients can meet or connect with each other. Both the donor and the recipient must agree. Your transplant team can explain the rules.

How do I get started?

Contact your transplant team to ask about the KPDPP.

Learn more about living donation and transplantation:

“Being part of a KPD transplant allowed me to help my husband live a normal life. I was also able to help another family live a normal life.” - Paired exchange donor

The OPTN helps create and define organ allocation and distribution policies that make the best use of donated organs. On an ongoing basis, it evaluates new advances and discoveries so it can refine policies to best serve patients waiting for transplants. All transplant programs and organ procurement organizations throughout the country are OPTN members and must follow the policies the OPTN creates for allocating organs.

Many thanks to New England Donor Services for sharing the information and illustrations in this brochure.