One of the factors driving the growth of chains is that donor surgery now is being performed laparoscopically. In the past, donating a kidney meant being hospitalized for up to a week; most of today’s donors leave the hospital the next day. Similarly, the amount of time donors would miss work in the past was two to three months, now it is typically only four to six weeks. With shorter recovery times for kidney donors, the relationship to the recipient has become more elastic. Originally, it was just family members who were able to donate, but over the years it has become acceptable for spouses, friends and now complete strangers to donate a kidney for transplantation. In 2011, a chain intertwined the lives of 60 strangers and involved the donation of 30 kidneys across the country; UCLA handled 16 of the patients, the largest number of any participating hospital. “The chain-transplantation program is truly remarkable, as it enables us to take the gift from a single altruistic donor and amplify it dozens of times,” Dr. Veale says. For more information and to watch a video about the UCLA Kidney Exchange Program, go to: transplants.ucla.edu/kidneyexchange Paired Donor Exchange Transplantation: If a donor and a recipient have a different blood type, they can exchange their kidneys with another donor and recipient pair in a similar situation. This can also be done among three pairs. Wife Donor Incompatible Husband Recipient Husband Recipient A donor chain creates opportunities for endless recipient-donor pairings. It starts with an altruistic donor — someone who wants to donate a kidney out of the goodness of his or her heart. That kidney is transplanted into a recipient who had a donor willing to give a kidney, but was not a match. To keep the chain going, the incompatible donor gives a kidney to a patient unknown to him or her who has been identified as a match. A specialized computer program matches donors and recipients across the country. Wife Donor Incompatible Chain Transplantation: Altruistic Donor #1 Sister Recipient #2 Wife Recipient #1 Brother Donor #3 Husband Donor #2 Wife Recipient #3 9 Husband Donor #4 UCLA Physicians Update