New England Program for Kidney Exchange (NEPKE) & Alliance for Paired Donation (APD)
Together with New England surgeons and tissue typing experts, especially Frank Delmonico and Susan Saidman, we (Alvin Roth, Utku Ünver and I) have launched the centralized New England Program for Kidney Exchange (NEPKE) in to cover six New England states (and 14 transplant centers) in 2004. NEPKE became the first kidney exchange program to use optimization in kidney exchanges. We have also been running matches for Drs. Steve Woodle and Michael Rees and their colleagues in the Paired Donation Consortium they started in Ohio, and subsequently for the Alliance for Paired Donation (APD). [ Media ]
Kidney Exchange and the US Federal Law
National Organ Transplant Act (NOTA) of 1984 prohibits “any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation…” When we initially helped found NEPKE, it was unclear whether kidney exchange is a violation of NOTA. Since then a bill that amends NOTA to clarify that “kidney exchange (or kidney paired donation) shall not be considered to involve the transfer of a human organ for valuable consideration has passed in the Senate.
The Birth of Kidney Chains
One of the tools we develop in our paper (w-chains) is based on the following idea: When a live-donor kidney becomes available for donation (through indirect exchange for instance), more than one patient can benefit if it is integrated with the kidney-exchange pool. See Johns Hopkins Medicine press release Three-Way “Domino” Kidney Transplant Includes a First for the first real-life application of this idea. In this application the live-donor kidney became available not through an indirect exchange but directly from a Good Samaritan donor (i.e. a non-directed donor).
The Birth of Never-Ending Altruistic Donor (NEAD) Chains
2012 Update: Non-simultaneous chains initiated by Good Samaritan donors (a.k.a. non-directed donors) became one of our most successful innovations in practice. Here is a April 2012 NSF Science Nation story focusing on the practical success of this innovation.
National Kidney Exchange in the US and UK
Our ideas are now implemented at national scale in the UK by NHS Blood and Transplant, and in the U.S. by OPTN!
Since 2009, NHS Blood and Transplant run National Matching Scheme for Paired and Pooled Kidney Donation in the UK.