[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

I’ve finally been contacted by a coordinator at the University of Toledo Medical Center where the Alliance for Paired Donation (APD) is headquartered to confirm my interest in donating a kidney through the never-ending altruistic donor (NEAD) program. Naturally, I say that I am.

Historically, living kidney donors were either a relative or friend of the recipient. However, oftentimes the potential donor is willing to give a kidney, but is incompatible with the recipient due to blood type or antibodies (more on the role of antigens in a later post).

To solve this problem, a set of incompatible donor-recipient pairs can be formed that exchange kidneys across pairs.  The National Kidney Registry and the Alliance for Paired Donation (the two organizations that I have signed up with) are pioneers in matching up these incompatible pairs. In some cases the number of pairs required in the exchange to ensure each recipient gets a compatible kidney can get quite large (more on software used to create chains of compatible donor-recipient pairs in a later post). In order to avoid having a donor break the chain after their loved one has received his/her kidney, the surgeries are performed simultaneously. This restricts the number of pairs that can be in the chain since there is a limit on the number of available operating rooms, surgeons, and other hospital resources.

The need to perform simultaneous surgeries can be reduced, or eliminated, if the first donor in the chain offers to donate their kidney with no recipient in mind. This altruistic donor allows the surgeries to be scheduled one at a time. If any future donor backs out, then the next pair in the chain is no worse off than before. Finally, the length of the chain can be unlimited if the donors never back out. This never-ending altruistic donation is a fairly new development and still rare. But in my mind it shouldn’t be. Why should someone with few friends or relatives be less likely to receive a kidney than someone from a large family or has many friends?