New Innovations in Transplantation to Ensure that the Need for Kidneys is Met

Rachyl Pines New Research from TREC, Transplant News

By Rachyl Pines, PhD, Postdoctoral Fellow

Dr. Waterman and Dr. Pines are the research committee leads for the National Kidney Registry (NKR), a non-profit organization whose mission is to “save and improve the lives of people facing kidney failure by increasing the quality, speed and number of living donor transplants in the world as well as protecting all living kidney donors.” Learn more about this organization by clicking here. The NKR has been a leader in innovating new ways to meet the kidney donor shortage. One of the most recent innovations is the Family Voucher Program.

The Family Voucher Program, which sometimes is also called Advanced Donation, is when a person donates in advance in case someone in their family needs a kidney transplant later on in their lifetime. The donor gets to choose up to five people in their family that will get a voucher. If one of those people needs a kidney in the future in their life, they can redeem that voucher. The benefits of donating in advance through the Family Voucher Program is that the person donating can trigger a chain of kidney donations to other people who need new kidneys immediately, rather than in the future when the intended receiver needs a kidney.

A helpful picture from the NKR website is below to show how chains work. The box titled “Good Samaritan Donor” represents the person donating into the Family Voucher Program. Some chains are as long as 30+ people!

Check out this web page for more information about how kidney paired exchange and donor chains work.

This innovative Family Voucher Program is a really exciting development, but we have to make sure through scientific testing, that it is actually going to help and that it will be doable. In a recent study with the NKR, we used statistical modeling to see if the need for kidneys for the family members who have vouchers would be able to be met with the people who are donating in advance. For example, is the family voucher program overpromising kidneys to people when there might not be enough for everyone? Some people worry when donating into the voucher program that there won’t be enough kidneys for their family member to redeem their voucher years later.

Using sophisticated statistical tests, the results showed that in all of the scenarios, the number of available kidneys donated in advance was more than the number of people who needed to redeem their voucher for a new kidney each year. The scenarios that the researchers tested were things like what if the need for kidney transplants slowly increases over time in the next 50 years? What if it quickly increases over time in the next 50 years? Or even what if the need increases quickly and decreases quickly in the next 50 years?

In all of these situations, the researchers found that the need for a kidney transplant by redeeming a voucher would be met. These findings are very exciting because this means that people donating through the Family Voucher Program can meet their family’s future possible needs of receiving a kidney transplant! These findings also help potential donors to gain confidence that when they donate in advance, the person who needs it in the future will be able to redeem their voucher.

The researchers describe this as similar to when you put your money in a bank, you confidently expect to be able to take it out and spend it any time. This is just as when you donate in advance, you can confidently expect a family member to be able to redeem your voucher any time they may need it, as these results indicate.

You can read the whole published study by clicking here