Living donor kidney transplant (LDKT) is the treatment of choice for patients with advanced kidney disease. Kidney paired donation (KPD), originally proposed to overcome immunological barriers, has now evolved to address biological and chronological incompatibilities and reduce financial disincentives. This strategy has allowed maximization of the number of LDKTs. In 2021, of the 5971 LDKT, 1115 (18.6%) were facilitated by KPD. While KPD programs vary in size and structure, privately owned KPD programs dominate the landscape. Participation in KPD is far from universal, as 40% transplant centers do not offer KPD. Across the nation, there are large areas devoid of transplant centers offering KPD. As a result, some donor and recipient candidates are missing opportunities for a successful LDKT. Some private KPD programs provide financial and legal protections to living donors. Therefore, access to such donor protections is variable and not available to all donors. In this perspective, we review the evolution of KPD programs, explore ways to enhance participation, discuss the need for transparency about living donation options to donor and recipient candidates, and ultimately, call for national action for regulatory oversight and to make living kidney donation financially neutral regardless of participation in KPD.

Abhishek Kumar

Angie G Nishio Lucar

Mona D Doshi

American Journal of Kidney Diseases

美国肾脏病杂志 (AJKD) 是美国国家肾脏基金会的官方期刊，在全球范围内被公认为临床肾脏病学内容的领导者。每个月 AJKD 都会发布原始调查报告，描述与肾脏疾病、高血压、透析疗法和肾移植相关的最新发现。除了对所有 AJKD 内容进行严格的同行评审外，原始调查还要接受例行的统计审查，并遵循一致的结构化格式。每一期的病例报告都揭示了新的疾病和潜在的治疗策略。

The American Journal of Kidney Diseases (AJKD) is the official journal of the National Kidney Foundation and is recognized globally as a leader in the field of clinical nephrology. Each month, AJKD publishes original research reports that describe the latest findings related to kidney disease, hypertension, dialysis, and kidney transplantation. All content in AJKD undergoes rigorous peer review, and original investigations are subject to routine statistical review and follow a consistent structured format. Each issue's case reports reveal new diseases and potential treatment strategies.

《美国肾脏病杂志》（American Journal of Kidney Diseases，AJKD）是美国国家肾脏基金会的官方期刊，全球公认的临床肾脏病学领域的领导者。每月，AJKD 发布原始研究报告，介绍与肾脏疾病、高血压、透析和肾移植相关的最新发现。所有AJKD的内容都经过严格的同行评审，原始研究还需接受例行的统计审查，并遵循一致的结构化格式。此外，每期的病例报告揭示了新的疾病和潜在的治疗策略。

Category	Quartile
医学	1
医学, 泌尿学与肾脏学	1

Pushing the Boundaries of Living Donation Through Kidney Paired Donation

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Journal Info

Category	Quartile
UROLOGY & NEPHROLOGY	1