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Journal of Transplantation
Volume 2015 (2015), Article ID 748102, 6 pages
Research Article

Alternative Living Kidney Donation Programs Boost Genetically Unrelated Donation

Department of Internal Medicine, Erasmus MC, s-Gravendijkwal 230, 3015 CE Rotterdam, Netherlands

Received 18 May 2015; Revised 20 August 2015; Accepted 24 August 2015

Academic Editor: Gaetano Ciancio

Copyright © 2015 Rosalie A. Poldervaart et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Donor-recipient ABO and/or HLA incompatibility used to lead to donor decline. Development of alternative transplantation programs enabled transplantation of incompatible couples. How did that influence couple characteristics? Between 2000 and 2014, 1232 living donor transplantations have been performed. In conventional and ABO-incompatible transplantation the willing donor becomes an actual donor for the intended recipient. In kidney-exchange and domino-donation the donor donates indirectly to the intended recipient. The relationship between the donor and intended recipient was studied. There were 935 conventional and 297 alternative program transplantations. There were 66 ABO-incompatible, 68 domino-paired, 62 kidney-exchange, and 104 altruistic donor transplantations. Waiting list recipients () were excluded as they did not bring a living donor. 1131 couples remained of whom 196 participated in alternative programs. Genetically unrelated donors (486) were primarily partners. Genetically related donors (645) were siblings, parents, children, and others. Compared to genetically related couples, almost three times as many genetically unrelated couples were incompatible and participated in alternative programs (). 62% of couples were genetically related in the conventional donation program versus 32% in alternative programs (). Patient and graft survival were not significantly different between recipient programs. Alternative donation programs increase the number of transplantations by enabling genetically unrelated donors to donate.