The First 9 years of Kidney Paired Donation Through the National Kidney Registry: Characteristics of Donors and Recipients Compared to National Live Donor Transplant Registries

The practice of kidney paired donation (KPD) is expanding annually, offering the opportunity for live donor kidney transplantation to more patients. We sought to identify if voluntary KPD networks such as the National Kidney Registry (NKR) were selecting or attracting a narrower group of donors or recipients compared to national registries. For this purpose, we merged data from the NKR database with the SRTR database from February 14, 2008 to February 14, 2017, encompassing the first 9 years of the NKR. When compared to all UNOS live donor transplants (49,610), all UNOS living unrelated transplants (23,319), and all other KPD transplants (4,236), the demographic and clinical characteristics of NKR transplants (2,037) appear similar to contemporary national trends. In particular, among the NKR patients there were a significantly (p 80%), females (45.9 vs. 37.6%), black recipients (18.2 vs. 13%), and those on public insurance (49.7 vs. 41.8%) compared to controls. These results support the need for greater sharing and larger pool sizes, perhaps enhanced by entry of compatible pairs and even chains initiated by deceased donors, to unlock more opportunities for those harder to match pairs.