Demand for kidneys far exceeds supply. As of July 2017, approximately 97,000 candidates are registered
on the OPTN Wait List for a deceased donor kidney. Kidney paired exchange chains have potential for
greatly increasing the number of transplants in the nation.

A study published in 2013 found that a non-directed donor triggers 4.8 transplants on average and 6 if the non-directed donor is a blood type O1. Although KPD chains may ultimately end in donation to the waitlist, deceased donor kidneys are currently not used to begin chains. Using deceased donor kidneys to initiate KPD chains could greatly expand the number of transplants overall as each deceased donor kidney could unlock multiple transplant
opportunities.

Deceased donor-initiated chains may also better utilize kidneys to maximize the potential of
KPD donors and deceased donors to increase the overall number of transplants.