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Even with a willing living donor, nearly a third of adult kidney transplant candidates will not match with their intended donor due to blood type or tissue incompatibility. Participating in kidney exchange programs, as we do at Froedtert Hospital, significantly improves access to potential compatible donors around the country.

Kidney exchanges also can dramatically decrease the time recipients need to wait for a kidney. The average wait time for a kidney transplant facilitated through the National Kidney Registry – of which Froedtert Hospital is a member – is 11 months.

How a Kidney Exchange Works

In a kidney exchange, a donor with an incompatible recipient is willing to donate a kidney to another recipient who has an incompatible donor. There are two types of exchange processes.

Looped or paired exchanges involve two pairs of donors and recipients. The original pairs of donors and recipients are not compatible, but they do match another pair. In the example below, the donor on the left donates to the recipient on the right, while the donor on the right donates to the recipient on the left.

Kidney chains involve more donors and recipients, so they have the potential to secure more compatible donors for recipients involved. Chains begin when a good Samaritan or non-directed donor steps forward, often on behalf of an incompatible recipient, and willingly gives a kidney to an unknown recipient. In return, the incompatible recipient will receive a kidney from another donor. 

Froedtert Hospital Involved in Second Largest Kidney Chain in the World

One kidney chain typically facilitates six transplants, but in some cases, many more may be involved. In 2013, the End-Stage Kidney Disease and Kidney Transplant Program at Froedtert Hospital was one of 19 in the United States involved in the world’s second largest kidney exchange in history, which involved 28 donors and 28 recipients.

FAQ and Resources

Transplant and the COVID-19 Vaccine

Transplant patients may be at a higher risk of severe COVID-19, and we have seen worse outcomes if they do get it. Due to the increased risk, we recommend transplant patients get the vaccine.