Growth of kidney donation by unrelated donors

Kidney exchange has allowed more people to receive kidneys from unrelated donors, but that isn't all that's going on, it has also become more acceptable for people to receive a kidney from friends and even people who they met on the internet.

George Taniwaki--a prospective donor who publishes a very interesting blog--has a post on this, The rise of unrelated donor transplants.

It includes admirably clear data graphics and analysis.

"Even more interesting is the extremely rapid rise of alternative sources of living donors. The last three lines from the figure above are rescaled in the figure below. The fastest growing source of living donors is paired exchanges. ... Kidney exchanges have the potential of becoming the leading source of live donor kidneys within a few years."

In addition, he has some insights into some of the complicated politics of kidney transplantation, in which there is some over-claiming of "firsts."

"The final fast-growing source of donors are people who donate without a specific recipient in mind. They are called nondirected or altruistic donors. Johns Hopkins Medicine claims to have performed the first nondirected live donor transplant in September, 1999. However, UNOS data shows two earlier donors in 1998 and one in 1988, the first year data is available. In addition to increasing the total number of donations, nondirected donors also play an important role in starting donor chains in kidney exchanges. Donor chains reduce the risk to recipients of their matched donors backing out an exchange after the first transplant takes place. Thus, nondirected donors reduce the need to perform the transplant surgeries simultaneously. This simplifies scheduling personnel and operating rooms for kidney exchange transplants."