People are connected in many ways: through family, friendships, school, work, sports, community, religious groups, on-line forums, acquaintances, and random acts of kindness. But these last connections, “random acts of kindness,” can vary widely from holding the door for someone to giving them an organ.
As the transplant waiting list grows, so does the need for people who are willing to take part in such a monumental act of kindness. There are now many people here in Maryland and hundreds more around the country who have been so kind—they are now connected through kidney paired donation (KPD) chains.

Graphic depicting a paired kidney exchange.
Kidney paired donation chains start with a recipient and living donor pair who are not a match for any number or reasons—most likely due to blood type. They are placed into a pool of other recipient and living donor pairs who are not a match and then the puzzle work begins. The Kidney Paired Donation program will then work to match up non-match recipients with non-match donors, until all matches are made, forming a chain. These chains can span many recipients, many hospitals, and many years. The current longest kidney paired chain is at 88 transplants and growing!
A Cross-Country Match

Though recipient Nadine and living donor Jennifer met for the first time after the transplant, they said they never felt like strangers.
Nadine Holleger from Delaware needed a kidney transplant. Her friend volunteered to be her living donor, but unfortunately, the two were not a match. Through the kidney paired donation program, Nadine was able to receive a kidney from living donor Jennifer in San Diego, and her friend was able to donate to a recipient in San Francisco. Coast to coast connections were made, and Nadine and her donor Jennifer were even able to meet about a year after the transplant.
Across the US there are many programs that facilitate kidney paired exchanges. The Organ Procurement and Trans- plantation Network (OPTN) manages the national UNOS Kidney Paired Donation program which began in 2010 to increase the number of paired transplants. Their vision is for every kidney transplant candidate with an incompatible, but willing and approved living donor, to receive a living donor kidney transplant. More than 40 states have transplant centers who participate in this program, including our two transplant centers here in Maryland— The Johns Hopkins Hospital and University of Maryland Medical Center.

When Neil (right) needed a kidney transplant, he was lucky to have not just one, but two friends step up! Britani (left) and Allison (not pictured) both ended up donating to the kidney paired exchange at JHH, one for Neil and one altruistically, giving Neil more time with his wife, Lisa (center).
Long or short, paired kidney chains can connect people near and far. Recipients with willing donors or willing donors without recipients can become part of these unique life-saving connections.
Interested in becoming a living donor? Find more information at www.thellf.org/ livingdonation.
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