What is the Australian Paired Kidney Exchange (AKX) Program?
The Australian Paired Kidney Exchange (AKX) Program is a nationwide living kidney donor program. The goal of the AKX Program is to increase live kidney donor transplants by identifying matches for incompatible donor/recipient pairs.
The AKX Program is part of the Organ and Tissue Authority’s (the Authority) efforts to increase available organs from living donors. Approximately 30% of potential donors fail to fulfill their wish to donate a kidney to a relative or friend due to incompatible blood group or tissue matches. Long-term results from living donor kidney transplants are excellent.
A paired kidney exchange can happen when a living donor (Donor #1), who is willing to donate to a spouse, friend or relative (Recipient #1), is unable to donate because they have an incompatible blood type or tissue type. The AKX Program will help find compatible donors amongst other registered pairs who might be a suitable match (such as Donor #2 and Recipient #2 shown below). This enables two compatible living donor transplants to occur.
How does the AKX Program work?
If you have a willing, but incompatible living donor, participation in the AKX Program will increase the chance that you will be able to receive a living donor kidney transplant.
Participants in the AKX Program are registered in the computer database containing all the registered donor/recipient pairs across Australia.
The computer program searches the entire available database of registered recipient/donor pairs to look for combinations that might enable a suitable kidney exchange to occur. If the computer finds a potential match, doctors from the participating transplant centres will determine whether to proceed with further medical testing.
If no match is found in the first match run, you and your donor will be kept on the register and will be included in further computer match runs. If no match is found after several match runs, other available options may need to be explored.
How can I join the AKX Program?
To register with the AKX Program you should contact your kidney specialist. You and your willing donor will be asked to:
- provide a detailed medical history
- undergo a number of medical tests
- have the program explained to you by a medical professional
- sign a consent form stating that you understand the AKX Program and agree to participate.
Who can participate?
If you are eligible for a kidney transplant, and are receiving care at a transplant centre in Australia, you may be able to participate in the AKX Program. You must have a living donor who is willing but unable to donate to you because of an incompatible blood type or tissue type. Your donor must be willing to take part and donate a kidney to someone else.
What happens if a match is found?
If a match is found, your kidney specialist will inform you. Further testing will be required to confirm that the recipient and potential donor are compatible. Once the testing is completed, each donor and recipient pair will meet with their own transplant team to discuss the results. After discussion, if the donor recipient pairs agree to the exchange, they will sign the appropriate consent forms for surgery.
If you are identified for a possible donor/recipient exchange, there is no guarantee that the transplant will occur. There are many physical and psychological issues to be considered in the AKX Program and the process is complex. You will receive advice and support to help you understand these issues.
Where would the transplant take place?
If all parties agree to an exchange, and are medically compatible, the two transplant surgeries take place at two different transplant centres. Each donor/recipient pair remains at their own transplant centre. Both operations occur at the same time (even if the other transplant is in another state). In this way, both donors are sure that each has gone through with the surgery. Each recipient receives their kidney on the same day as their friend or relative donates.
Can I contact the other couple?
No. Strict privacy and confidentiality will be maintained for each donor/recipient pair. One of the reasons for using different hospital sites for the two pairs of donors and recipients is to protect the privacy of the donor/recipient pairs throughout the AKX Program and into the future.
Can I change my mind after I have joined the AKX Program?
Donors and recipients can change their minds at any time leading up to, and including the day of surgery. The donor operations are coordinated to be performed at exactly the same time so that neither party is disadvantaged if, in the rare event, one member of a donor pair wants to withdraw from the exchange donation at the last minute.
What is the chance of finding a match?
The chance of finding a suitable match depends on a number of factors. The more donor/recipient pairs registered on the AKX Program database, the greater the chance of finding a match.
If a patient has more than one donor who is willing to enter the program, they have a greater chance of finding a match. Only the donor with the best match will actually donate their kidney. Individuals with common blood types and low levels of sensitisation to other blood and tissue antigens will also have a greater chance of matching.
Alternatively, your doctor may discuss other options.
What happens if no match is found?
Patients who don’t find a matching donor through the AKX Program still have a chance of receiving a kidney transplant as they will remain on the deceased donor transplant waiting list. The chance of finding a successful match for exchange should increase as more donor/recipient pairs join the AKX Program. If no match is found, you can remain on the register and re-enter the match runs. However if no suitable pair matches are found after a period of time, you may wish to consider other options after discussion with your kidney specialist.
What should I do next?
For more information, ask your kidney specialist. Counselling support will be available to donor and recipient pairs through the transplant centre both before and after the paired kidney exchange.
Contact the AKX Program for more information about registering or contact the AKX Program National Coordinator at 08-9431 3690.
A program of the Australian Organ and Tissue Donation and Transplantation Authority.