Paired Exchange Program in Istanbul for Incompatible Donor–Recipient Pairs
Our computer-based Paired Exchange Program in Istanbul is designed to match incompatible donor–recipient couples and help them receive a safe and successful kidney transplant. The primary goal of a paired exchange program is to support medically suitable but incompatible pairs—due to blood group or tissue type—by helping them find other compatible pairs so that transplantation can proceed.
We collaborate with multiple transplant centers in Istanbul and share our registry with the Paired Kidney Donation Program in the United States. This broad coordination helps overcome the limitations of single-center programs and expands opportunities for patients with immunologic barriers.
Paired exchange programs aim to provide recipients with a kidney that is a better match than the one their original donor could offer. This may mean a kidney with better HLA compatibility, from a younger donor, or one that is better matched in size. A key objective is to find donors who are mismatched only in ways that do not trigger strong immune reactions. This improves long-term graft survival and reduces the risk of delayed kidney function. By joining the program, candidates may receive a transplant sooner, spend less time on dialysis, or avoid dialysis entirely.
Expanding Access for Incompatible Pairs
The program supports donor–recipient pairs who cannot proceed with a direct transplant due to ABO blood group mismatch or HLA incompatibility. By matching them with other pairs, the program makes transplantation possible for patients who would otherwise have no compatible donor.
Improving Match Quality
The system prioritizes matches that minimize immunologic risk. It seeks donors who are mismatched only in ways that do not provoke strong immune responses. This approach supports better graft survival and reduces complications after transplantation.
Minimizing Medical and Financial Risks
- Avoiding Desensitization — The program reduces the need for costly and complex desensitization treatments such as plasmapheresis or high-dose immunosuppression. These treatments can increase infection risk and overall healthcare costs. By focusing on compatible matches instead of desensitization, the program lowers both medical risks and financial burden for patients and the healthcare system.
Promoting Equity and System Balance
- Serving Special Populations — The program improves access for patients who are traditionally difficult to match, such as children and highly sensitized individuals with many antibodies. It also prioritizes groups who face greater challenges, including patients with blood type O, and ensures that O-type donors are used efficiently to benefit those who need them most.
- Encouraging Participation — Compatible donor–recipient pairs are also encouraged to join the registry. By offering the possibility of an even better-matched kidney, the program attracts more donors—especially those with blood type O—expanding the pool and improving outcomes for all participants.
