Successful expansion of the living donor pool by alternative living donation programs

Am J Transplant. 2009 Sep;9(9):2150-6. doi: 10.1111/j.1600-6143.2009.02745.x. Epub 2009 Jul 16.


Between January 2000 and December 2007, 786 potential recipients and 1059 potential donors attended our pretransplant unit with the request for a living-donor renal transplant procedure. The recipients brought one potential donor in 77.2% and two or more donors in 22.8% of cases. In the regular living donor program, a compatible donor was found for 467 recipients. Without considering alternative donation, 579 donors would have been refused. Alternative living donation programs led to 114 compatible combinations: kidney-exchange program (35), ABO-incompatible donation (25), anonymous donation (37) and domino-paired anonymous donation (17). Together, the 114 alternative program donations and the 467 regular living donations led to 581 living donor transplantations (24.4% increase). Eventually for 54.9% (581/1059) of our donors, a compatible combination was found. Donor-recipient incompatibility comprised 19.4% (89/458) in the final refused population, which is 8.8% of the potential donor-recipient couples. Without considering alternative donation, 30.1% (174/579) of the refused donors would have been refused on incompatibility and 6.4% (37/579) because they were anonymous. This is 20% of the potential donor population (211/1059). The implementation of alternative living donation programs led to a significant increase in the number of transplantations, while transplantations via the direct donation program steadily increased.

MeSH terms

  • ABO Blood-Group System
  • Adult
  • Altruism
  • Blood Group Incompatibility*
  • Donor Selection / methods*
  • Female
  • Histocompatibility Testing / methods
  • Humans
  • Kidney Transplantation / methods*
  • Living Donors
  • Male
  • Middle Aged
  • Program Evaluation
  • Tissue and Organ Procurement / methods*


  • ABO Blood-Group System