The ANZKX program is a collaborative trans-Tasman living donor kidney transplant program involving centres in Australia and New Zealand.
The primary goal of the program is to increase living donor kidney transplants by identifying matches for incompatible donor-recipient pairs. An additional goal of ANZKX is to improve immunological matching for compatible donor-recipient pairs. The ANZKX team can discuss options with transplant units prior to entry of compatible pairs to ensure the program matches needs.
From 2021, continuous matching is performed so units are encouraged to enrol pairs as soon as they are ready.
Please contact the ANZKX team to discuss any specific matching needs of your donor-recipient pairs.
Feedback can be given to transplant units on how to improve the probability of pairs being matched in the program.
Registering a patient in the program
Donor and recipient pairs are registered into the ANZKX program by creating a KPD enrolment in OrganMatch via the Transplantation Portal. This is performed by transplant coordinators as outlined in the ANZKX Protocol. Test results, patient consent and ministerial approval forms are also uploaded to this system.
Further information and training resources regarding the use of the Transplantation Portal can be found in the OrganMatch training hub and documents for Kidney Paired Donation (KPD) are linked below.
When a pair is registered, the transplant unit can contact the ANZKX team for any specific matching needs.
Protocols and forms
When a pair is being registered in the ANZKX program, the unit should ensure compliance with the ANZKX protocol, including consent procedures as documented below.
If you have any queries about the following protocols and forms, please contact the ANZKX team directly.
- Protocol 1 ANZKX national protocol (1.4 MB PDF)
- Protocol 2 Process of the ANZKX program (774 KB PDF)
- Protocol 3 Living donor evaluation guidelines (984 KB PDF)
- Protocol 4 ANZKX tissue typing laboratory guidelines (918 KB PDF)
- Protocol 5 Agreement to participate and Ministerial approval process (654 KB PDF)
- Protocol 6 Guidelines for packaging and transport (1.9 MB PDF)
- Protocol 7 Donor nucleic acid testing (563 KB PDF)
- Protocol 8 Recommended donor CTA protocol, construction and reporting standard (828 KB PDF)
- Protocol 9 Pathway for inclusion of compatible pairs in the ANZKX program (645KB PDF)
- Protocol 10 Latent tuberculosis pathway for donors (685 KB PDF)
- Protocol 11 Coronavirus Disease 2019 (COVID-19) testing (570 KB PDF)
- Protocol 12 Media protocol for the ANZKX program (891 KB PDF)
- ANZKX - Registration and Enrolment (PDF)
- Kidney Paired Donation (KPD) Enrolment (PDF)
- Kidney Paired Donation (KPD) Registration (PDF)
Forms for download
- Form 1 Frequently asked questions (554KB PDF)
- Form 2 Information for donors and recipients (1.03MB PDF)
- Form 3 Donor agreement to participate (252KB PDF)
- Form 4 Donor declaration form (205KB PDF)
- Form 5 Recipient agreement to participate (249KB PDF)
- Form 6 Hepatitis B antibody positive donors (136KB PDF)
- Form 7 Latent tuberculosis donors - recipient consent (240KB PDF)
- Form 8 Informed consent discussion checklist (532KB PDF)
- Form 9 Ministerial approval form (364KB PDF)
- Form 11 Surgical checklist (356KB PDF)
- Form 12 Day of exchange details (450KB PDF)
- Form 13 Transport itinerary and contingency plan (216KB PDF)
- Form 14 Living kidney donation report form (314KB PDF)
- Form 15 Hepatitis C antibody donor recipient consent form (630 KB PDF)
- Form 16 ANZKX Post Transplant Follow up (1 month) (143 KB PDF)
Compatible pairs and ANZKX
A compatible pair may be considered suitable for participation in ANZKX, particularly if there is a high degree of HLA mismatch or poor eplet matching. Participation in ANZKX can particularly benefit younger patients, who may need another transplant in the future.
ANZKX does not match compatible pairs to improve age difference between donor and recipient.
For further information see the ANZKX compatible pair protocol (645KB PDF).
If you have any queries about a compatible pair, please contact the ANZKX team to discuss the options available.
Out of ANZKX protocol criteria donors
The ANZKX national protocol (1.4 MB PDF) has set criteria for participation.
Transplant units can discuss with the ANZKX medical team if they have any donors who do not meet the program’s criteria but they believe should still be accepted. If one of these donors is allowed to be enrolled, then these details will be provided to the recipient unit if they are matched.
Out of donor criteria patients should be counselled that they might be harder to match and hence wait longer in the program.
Resources for outpatient clinics
The characteristics of incompatible donor pairs differ and, in order to appropriately inform patients of their chances of being matched, the following resources may be useful.
- The ANZKX program has facilitated over 400 kidney transplants since its inception in 2010 and now has approximately 50 transplants occurring each year.
- On average, the number of registered pairs in the program at any time is between 60 and 90.
- 57% of all recipients registered have received a transplant through the program.
- The majority of matches are made in the first 6 to 12 months after a pair is entered. The matchability of donor and recipient will influence the waiting time for a match.
- Patient and graft survival outcomes at one and 5 years when pursued through the ANZKX program are excellent and equivalent to transplant outcomes for live donor directed donation.
The ANZKX program aims for the time from match to transplant to be 4 to 8 weeks. In order to achieve this, transplant units should make a decision about an offer within 48 hours and ensure surgical teams’ agreement within 7 days. This requires surgical review of the CT renal angiogram and discussion between all surgeons involved.
Please see further information regarding the offers to transplant timeline here via the ANZKX offers to transplant pathway (PDF).
Since 2021 ANZKX has moved to continuous matching and no longer performs match runs. By performing continuous matching, the program aims to reduce the waiting time from match offer to transplant to approximately 60 days or less. Historically, with match runs the average waiting time was around 100 days.
Please see further information regarding the updated enrolment and registration process here via the ANZKX registration pathway (PDF).
The matchability of a pair is dependent on donor and recipient blood group and cPRA. In particular, if a recipient is blood group O with cPRA>97%, a transplant unit should consider discussing how to improve the match potential.
Please see contact details for the ANZKX team in both Australia and New Zealand below, or email ANZKX@mh.org.au.