The Canadian Kidney Paired Donation Program

In Brief Background Establishment of a national kidney paired donation (KPD) program represents a unique achievement in Canada’s provincially organized health care system. Methods Key factors enabling program implementation included consultation with international experts, formation of a unique organization with a mandate to facilitate interprovincial collaboration, and the volunteer efforts of members of the Canadian transplant community to overcome a variety of logistical barriers. Results As of December 2013, the program had facilitated 240 transplantations including 10% with Calculated panel reactive antibody (cPRA) ≥97%. Unique features of the Canadian KPD program include participation of n = 55 nondirected donors, performance of only donor specific antibody negative transplants, the requirement for donor travel, and nonuse of bridge donors. Conclusion The national KPD program has helped maintain the volume of living kidney donor transplants in Canada over the past 5 years and serves as a model of inter-provincial collaboration to improve the delivery of health care to Canadians. This report highlights the experiences and accomplishments of a newly instituted kidney paired donor exchange program in Canada. The unique features and variables of the Canadian program suggest alternative ways to construct paired exchanges.