The New England Program for Kidney Exchange (NEPKE) is a
recently established registry program that allows incompatible
donors to help their loved ones or friends to receive a living
donor kidney by matching one incompatible donor/recipient
pair with another incompatible pair.
NEPKE has been developed to overcome biological obstacles
for transplant candidates who have a willing living kidney
donor but whose donor has been unable to donate because of
an incompatible blood type or incompatible crossmatch. For
example, Ms. Jones has blood type A and would like to donate
her kidney to Mr. Jones, who has blood type B. Since the
donor and recipient do not match blood types, the transplant
cannot be done.
NEPKE enters basic medical information about the kidney donor
and their intended recipient into a confidential database.
Using a computer program, NEPKE determines if a donor exchange
is possible by matching a donor in one pair with a compatible
recipient of another pair.
An example of NEPKE matching is shown by the following: Mr.
Smith has blood type B and wants to donate to Mrs. Smith,
who is blood type A. Mrs. Jones has blood type A and wants
to donate to Mr. Jones, who is blood type B. If each of the
donors are medically suitable to undergo the operation and
each agree to an exchange, then Mr. Smith could donate to
Mr. Jones and Mrs. Jones would donate to Mrs. Smith.
In addition to a two-pair kidney exchange,
the NEPKE computer program allows the possibility of kidney
exchange between three donor/recipient pairs, increasing
the number of transplants performed.
An example is that Mr. Smith has blood type B and wants to
donate to Ms. Smith, who is blood type O. Ms. Jones has blood
type A and wants to donate to Mr. Jones, who is blood type
B. Mr. Brown has blood type O and wants to donate to Ms.
Brown, who is blood type A. Even though Mr. Brown's O blood
is compatible with Ms. Brown's A blood, they are incompatible
due to a positive cross-match (Ms. Brown has a reaction to
Mr. Brown's blood).
In this instance, Mr. Smith would donate to Mr. Jones, Ms.
Jones would donate to Ms. Brown, and Mr. Brown would donate
to Ms. Smith.
The recipient's transplant will occur at the center they receive
care. The donor would travel to the transplant center of their
matched recipient for the donation surgery. Keeping the donor
and recipient nearby decreases risks involved in moving the
donated kidney to a different transplant center and shortens
the interval between recovery of the organ and its transplantation.
All surgeries, both donor and recipient, are performed on
the same day, with the donor surgeries taking place at the
same time.
In other words the donor leaves the operating room having
given a kidney the same day that their loved one leaves the
operating room having received a kidney.
The program is designed to serve potential recipients that
meet the following criteria:
Be a patient eligible to receive a kidney transplant
Have a willing living donor who is unable to donate because
of an incompatible blood type of positive crossmatch test
Potential donors must also meet criteria to participate in
NEPKE:
Be willing to donate to a friend or relative but is unable
to donate because of an incompatible blood type or positive
crossmatch test
Complete a series of medical and psychological tests
Be willing to travel to a transplant center in Maine,
NH, CT, MA, or RI for their donation
How do I register in NEPKE?
Contact NEPKE for more information
about registering.
