Type of Living Donations

Living kidney donations can come from several different sources.


Related living donors are healthy blood relatives of the person in need of a kidney.

These include:

  • Parents
  • Siblings (brothers and sisters)
  • Children over 18 years of age
  • Other relatives in the same bloodline (aunts, uncles, cousins, half brothers and sisters, nieces and nephews)



Unrelated living donors are not directly (blood) related to the transplant candidate, but they are traditionally emotionally close to that individual. 

They include:

  • Spouses
  • In-law relatives
  • Close friends
  • Neighbors, co-workers, or other acquaintances



Living donors who don’t know the recipient and simply want to make a donation out of selfless motives are considered non-directed. These types of donations are also called anonymous, altruistic, altruistic stranger and stranger-to-stranger donors. People interested in becoming non-directed donors are encouraged to contact a transplant center in their area to discuss the possibility of becoming a donor.


Paired Kidney Donation

When there is a willing living kidney donor, but not a match for the intended recipient, a paired (exchange) donation can still make the transplant a reality. In this process, two kidney donor/recipient pairs whose blood types are not compatible trade donors so that each recipient can receive a kidney with a compatible blood type. In some cases, this type of exchange has involved multiple living kidney donor/transplant candidate pairs.


Kidney Donor Waiting List Exchange

When someone wants to donate a kidney, but a paired exchange is not possible because a suitable match cannot be found, living donors (in certain areas of the country) may be eligible for a living kidney donor list exchange. Here, a kidney donor who is not compatible with their intended recipient may offer to donate to a stranger on the waiting list.  After that transplant occurs, the intended recipient advances on the waiting list for a deceased donor kidney. This type of living donation is also referred to as list-paired exchange and living donor/deceased exchange.


Blood Type Incompatible

Traditionally, a donor and recipient must have compatible blood ypes to avoid rejection of the transplanted kidney.  However, this new approach allows candidates to receive a kidney from a living donor whose blood type does not match that of the recipient. For this procedure, recipients undergo plasmapheresis treatments before and after the transplant to remove harmful antibodies from the blood. This helps prevent immediate rejection of the transplanted kidney.


Positive Crossmatch

People who have had a previous transplant(s), pregnancies or blood transfusions can develop antibodies to the tissue or blood they have received. As a result, they can have a ‘positive crossmatch’ when blood and tissue typing is done against a potential donor. The positive crossmatch process is similar to the process used for Blood Type Incompatible living-donor kidney transplants and removes the previously-generated antibodies from the recipient prior to transplant using plasmapheresis to reduce the chances of organ rejection due to high levels of antibodies. In the past, high antibody levels made for an almost certain kidney rejection. This process is typically performed only when no other living donors (with a negative crossmatch) exist.




Number of kidney transplants performed in the United States. Learn More