No abstract

LDN is technically feasible and safe, and recipient graft outcomes are equivalent. Convalescence is shortened, and there is less personal financial loss. LDN offers significant benefit to the donor and may result in increased organ donation.

The increasing need for kidney transplants has led to innovations such as donor exchange programs. These programs offer transplant recipients with incompatible donors an opportunity to receive a compatible kidney. They also provide an alternative to costly desensitization protocols that have unproven long-term outcomes. Donor exchange programs have multiple options including simple two-pair exchanges, more complicated domino exchanges, or chain donations. The United States is currently limited by regional programs that provide for kidney donor exchanges. However, with the increasing public interest in and need for kidney transplants, general nephrologists will be approached with questions about these donor exchange programs. The goal of this review is to discuss donor exchange programs including their role in expanding the donor pool, the various types of exchanges, regional centers that provide these programs, and the process involved in patient enrollment. A general knowledge of donor exchange programs will help providers in discussing options with patients approaching end-stage kidney disease and transplant.