A Transplant for Tara - Kidney Version

08/30/2026

About ten years ago, actor Jesse Eisenberg decided he wanted to give a kidney to a stranger. He contacted an organization to ask how, and nobody ever wrote back. That was the end of it until recently, when he mentioned the idea to a friend who works in medicine. She pointed him in the direction of NYU Langone Health in Manhattan.

He was in the hospital the next day going through the workup.

On October 30, 2025, he announced the news on the Today Show more or less by accident in the middle of a conversation about his blood donation habit. “I’m actually donating my kidney in six weeks,” he said. “I really am.”

He donated on December 30th. The technical term is “non-directed donation,” sometimes called “altruistic donation” (though transplant centers prefer the former on the grounds that all living donation is altruistic). The kidney goes to the best match on the list and the donor never finds out the recipient’s identity.

Eisenberg points out how strange it is that more people don’t do it. “When I heard about kidney donations, my first thought was, why is there not a line down the block of the hospital?” he told Dr. Mike Varshavski while on The Checkup with Doctor Mike podcast.

Months out from surgery, he told NYU Langone he’d had no lifestyle changes, no limitations, and no regrets. “I wish I had more kidneys to give,” he said.

08/14/2026

Although this talks about the US registry this is also an option right here in Alberta (or anywhere in Canada). This is my most likely way of finding a match as I have type O blood AND a high (96) HLA rating. It would be amazing if someone out there would be willing to be my paired kidney donor. 💚💜

🔗 YOUR PARTNER WANTS TO GIVE YOU A KIDNEY. THEY HAVE BEEN TESTED. THEY ARE HEALTHY. THEY ARE WILLING. AND THEN THE PHONE CALL: THEIR BLOOD TYPE IS INCOMPATIBLE WITH YOURS. THE DONATION CANNOT PROCEED.

For years, this was the end of the story. A willing, generous, healthy donor - and a recipient who could not receive their kidney. The donor went home. The recipient returned to the waiting list.

Paired kidney exchange changed this story entirely.

Today, an incompatible donor-recipient pair is not a failed donation. It is an opportunity - a link in a chain that can produce transplants not just for the original pair, but for two, five, ten, fifty, or even a hundred other pairs simultaneously. A single willing donor who cannot give directly to their intended recipient can, through the mathematics of exchange, generate a cascade of transplants that spans an entire country.

The mathematics behind this earned a Nobel Prize in Economics in 2012. The human reality behind the mathematics is one of the most extraordinary stories in modern medicine.

Today we are explaining paired kidney exchange completely - how it works, who benefits most, what the logistics involve, and how every incompatible pair can access this option.

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🔬 THE PROBLEM PAIRED EXCHANGE SOLVES:

Living kidney donation produces the best transplant outcomes of any modality - better graft survival, better patient survival, and the option of pre-emptive transplantation before dialysis begins (Day 33, Day 80).

But approximately 30% of willing living donors are incompatible with their intended recipient:

BLOOD TYPE INCOMPATIBILITY:
ABO blood typing determines basic compatibility:
- Blood type O donors can give to any recipient - but can only receive from type O donors
- Blood type A donors can give to A or AB recipients
- Blood type B donors can give to B or AB recipients
- Blood type AB donors can receive from anyone - but can only donate to AB recipients

A type O donor intending to give to their type B partner is incompatible. Their kidney cannot be transplanted directly.

HLA INCOMPATIBILITY (CROSSMATCH POSITIVE):
Even with compatible blood types, a recipient may have pre-formed antibodies against specific HLA antigens on the donor's cells - a positive crossmatch - making the transplant high-risk for hyperacute rejection.

Highly sensitised patients (high cPRA - Day 78) face this problem with most potential donors.

BEFORE PAIRED EXCHANGE: Both problems were dead ends. Incompatible donors went home. Sensitised recipients waited years longer on the deceased donor list.

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📊 HOW PAIRED EXCHANGE WORKS - FROM SIMPLE SWAPS TO NATIONAL CHAINS:

THE TWO-WAY EXCHANGE (THE ORIGINAL CONCEPT):

Pair 1: Donor A (blood type O) - Recipient A (blood type B) - incompatible
Pair 2: Donor B (blood type B) - Recipient B (blood type O) - incompatible

Solution:
- Donor A gives their type O kidney to Recipient B (who needs type O)
- Donor B gives their type B kidney to Recipient A (who needs type B)
- Both transplants proceed simultaneously - each donor gives, each recipient receives

This is the simplest form of paired exchange - a direct two-way swap between two incompatible pairs who are compatible with each other's donors.

THREE-WAY AND MULTI-WAY EXCHANGES:

Not all pairs can be matched in two-way swaps. Some pairs require three-way or four-way chains to find compatibility:

Pair 1: Donor A (type O) - Recipient A (type AB) - incompatible
Pair 2: Donor B (type AB) - Recipient B (type A) - incompatible
Pair 3: Donor C (type A) - Recipient C (type O) - incompatible

Solution:
- Donor A gives to Recipient B (compatible)
- Donor B gives to Recipient C (compatible)
- Donor C gives to Recipient A (compatible)

Three donors. Three recipients. Three transplants. None would have been possible without the chain.

THE NATIONAL KIDNEY REGISTRY (NKR) AND NATIONAL CHAINS:

The National Kidney Registry (NKR) in the United States operates the largest paired exchange programme in the world - maintaining a pool of hundreds of incompatible pairs simultaneously and running the matching algorithm to find the optimal set of exchanges that maximises total transplants.

The logistics:
- Incompatible pairs register with the NKR through their transplant centre
- The matching algorithm runs continuously - identifying compatible chains across all registered pairs
- When a match is found, transplant centres are notified and surgeries are coordinated - often across multiple hospitals simultaneously
- Kidneys travel between hospitals packed in preservation solution; donors and recipients do not need to travel
- Surgeries are performed simultaneously where possible - to prevent any donor in the chain from withdrawing after their recipient has already received a kidney

CHAIN LENGTH RECORDS:
- The longest NKR chain completed as of 2024: over 100 transplants linked across dozens of hospitals
- These mega-chains are initiated by non-directed altruistic donors - strangers who donate to no specific recipient, launching a chain that propagates across the registry
- Each altruistic donor effectively "seeds" a chain that may produce 5, 10, 20, or 100 transplants from their single act of generosity

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🕊️ THE ALTRUISTIC NON-DIRECTED DONOR - THE MOST POWERFUL FORCE IN TRANSPLANT MEDICINE:

A non-directed altruistic donor is someone who wishes to donate a kidney to a stranger - with no specific recipient in mind.

In standard living donation, this altruistic donor would give their kidney to the highest-priority patient on the deceased donor waiting list - producing one transplant.

In paired exchange, the same altruistic donor becomes the starting link in a chain:
- Their kidney goes to a recipient in an incompatible pair
- That pair's donor - now freed from giving to their own incompatible recipient - gives their kidney to the next compatible recipient in the chain
- And so on - each freed donor becoming the next link

The chain continues until it reaches a recipient who has no associated donor - typically a highly sensitised waitlist patient who receives the final kidney in the chain.

One altruistic donor. One kidney. Ten, twenty, one hundred transplants - depending on how many compatible pairs are available in the registry at the time.

The mathematical beauty: the altruistic donor does not give more than any other donor (one kidney). But by entering the exchange pool rather than giving directly, they unlock an arbitrarily long chain of exchanges that would otherwise never occur.

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💉 WHO BENEFITS MOST FROM PAIRED EXCHANGE:

BLOOD TYPE O RECIPIENTS:
The most disadvantaged group in both deceased donor allocation (Day 78) and direct living donation - because O donors can give to anyone but O recipients can only receive from O donors. In a paired exchange, O recipients with non-O donors can be matched with O donors in other incompatible pairs.

HIGHLY SENSITISED PATIENTS (HIGH cPRA):
Patients with cPRA above 80% have a very restricted pool of compatible deceased donors. Paired exchange dramatically expands their compatible living donor pool - because the exchange algorithm searches across hundreds of living donors to find one compatible with their specific antibody profile.

The virtual crossmatch: modern paired exchange programmes use virtual crossmatch technology - testing the recipient's antibodies against a large panel of potential donors in the registry without physically mixing blood. This allows rapid identification of compatible chains without the logistical burden of shipping blood samples between centres.

RECIPIENTS WHOSE DONORS ARE WILLING BUT CROSSMATCH-POSITIVE:
A donor who is blood-type compatible but crossmatch-positive (the recipient has specific antibodies against that donor's HLA) can still participate in paired exchange - their donation goes to a recipient who is crossmatch-negative with them, freeing a compatible donor for their original recipient.

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🌍 PAIRED EXCHANGE AROUND THE WORLD:

Paired exchange programmes now operate in many countries - though with varying scale and sophistication:

- United States: NKR (National Kidney Registry) and UNOS paired exchange programme - the largest and most sophisticated globally
- United Kingdom: NHS Blood and Transplant runs the UK Living Kidney Sharing Scheme - one of the most successful national programmes relative to population size; international exchanges with Netherlands and other European partners
- Canada: Canadian Living Donor Exchange Program
- Netherlands: Dutch Kidney Exchange Program - pioneered many of the algorithmic advances in exchange matching
- Australia: Australian Paired Kidney Exchange (AKX) programme
- Many other countries running national or regional programmes

The future - international chains: preliminary programmes linking incompatible pairs across national borders are being explored - potentially allowing a highly sensitised patient in one country to be matched with a compatible donor registered in another.

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✅ HOW TO ACCESS PAIRED EXCHANGE:

If you have a willing living donor who has been found to be incompatible:

1️⃣ Ask your transplant centre: "Are we eligible for paired kidney exchange - and is this centre registered with the national exchange programme?"
2️⃣ Register with the national programme: your transplant centre coordinates registration; both donor and recipient must be enrolled
3️⃣ Understand the wait: matching depends on the registry pool at any given time - some pairs match quickly, others wait months
4️⃣ Ask about non-directed altruistic donation: if you know someone willing to donate to a stranger, they can seed a chain that produces your transplant as one of its links
5️⃣ Consider multi-centre registration: as with deceased donor waiting lists (Day 78), registration with programmes at multiple centres may access larger matching pools

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💬 The bottom line:

Paired kidney exchange is one of the most elegant solutions in the history of medicine - a mathematical framework that converts incompatibility into opportunity, transforms one generous act into dozens of transplants, and gives hope to patients who were told their donor could not help them.

If you have a willing donor who was told they cannot give to you directly - the conversation about paired exchange should happen immediately. The incompatibility is not the end of the story. It may be the beginning of a chain.

And if you are considering non-directed altruistic donation - to no specific recipient, to a stranger - know that your single kidney may launch a chain that saves ten, twenty, or one hundred lives. There is no more powerful act of generosity available to a living human being.

📌 RESOURCES:
- National Kidney Registry (US): kidneyregistry.org
- UNOS Paired Donation: unos.org
- NHS Living Kidney Sharing Scheme (UK): nhsbt.nhs.uk
- Canadian Living Donor Exchange: kidneyregistry.ca
- Australian Paired Kidney Exchange: anzdata.org.au
- American Transplant Foundation - Paired Exchange: americantransplantfoundation.org

Please SHARE this post - every incompatible pair who discovers paired exchange may find the path to a transplant they thought was impossible. 💚

❓ Have you or your donor been through a paired kidney exchange - and what was the experience like? Or have you recently been told your donor is incompatible - and has paired exchange been discussed? Comment below 👇

07/29/2026

There are a lot of preconceived notions from some that a person gets kidney disease because of something they did or didn't do. What they did or didn't eat, how often they exercised or didn't, and the list goes on. The fact is, I am in end stage renal disease and the specialists don't know why. It has nothing to do with what I did or didn't do.
What I also know is that while I wait for a kidney transplant from a donor (I am still looking) I am very grateful that I am able to do peritoneal dialysis. There is no cure for chronic kidney disease, but fortunately there is dialysis as a treatment option that keeps me alive. 💚💜



*Interestingly this image came from a site called dialysis sucks. Personally I don't think it sucks. I know I wouldn't be here without it. 💚💜

06/16/2026

Hello - Please read, consider, and share - thank you! 🩷

Today I am reaching out specifically looking for someone who would be interested in being a paired living donor. The reason I am doing this is because, although I have had some amazing humans look into being a living donor for me, they have not been a match. In reality, the odds for me finding a match from a living donor are not good. Because I have high antibodies it makes it only a 4% chance. BUT, that chance can be significantly increased if the person who is interested in being my living donor is also willing to be in the Kidney Paired Donation Program! That way if they are not a direct match for me there is still another option.

What is kidney paired donation?
Imagine you want to donate one of your kidneys to someone who needs a transplant. However, medical tests show that you are not a good match for them. Another potential donor and their transplant candidate are in the same situation. Turns out you are a match for the transplant candidate in the other pair, and the potential donor in that pair is a match for your person Swapping donors in these two pairs makes two transplants possible.
Kidney paired donation is a program that matches transplant candidates with suitable living donors. It gives people the chance to become a living kidney donor while ensuring that someone they want to help receives a needed kidney, even if they are not a direct match.

How does kidney paired donation work?
To enroll in the Kidney Paired Donation program, each donor and candidate must sign a consent form giving permission for their medical information to be entered in the Canadian Transplant Registry. This registry is a secure computer database for the Kidney Paired Donation program. Canadian Blood Services manages the Registry and the computerized matching process.
Specific personal and medical information for all enrolled donors and transplant candidates is entered into the Registry to allow matching. The Registry tries to find potential donors who can be matched to transplant candidates anywhere in the country. Once matched, a donor may need to repeat some medical tests or have other tests done to make sure their kidney is suitable for the matched transplant candidate.

Once all matches in the chain have been approved, donors from incompatible pairs are swapped to create compatible pairs. The transplant teams across the country work together to arrange the donation and transplant surgeries. The goal is to find better matching donors for the transplant candidate

Benefits of the Kidney Paired Donation Program

For transplant candidates:
For patients who have end-stage kidney disease and are eligible for a kidney transplant, a kidney from a living donor is the best treatment.
A kidney from a living donor usually lasts longer than a kidney from a deceased donor.
A living kidney donation can reduce or even prevent the patient’s need for dialysis.
Every patient who receives a transplant from a living donor comes off the wait-list for a kidney from a deceased donor. This shortens the wait-time for other patients on the transplant waitlist.
The donation and transplant operations can be planned for a time when both the potential donor and the transplant candidate are in the best possible health. Being in good health improves the recovery after surgery.

For potential donors:
You can help someone you know who needs a kidney transplant, even if you’re not a match for that person.
Many people who have donated a kidney say that helping someone in need is a positive personal experience
You can donate anonymously to help others receive their kidney transplants.
You can improve the life and health of the patient who receives your kidney.
You can improve the lives of the patient’s family members as well.

Additional Information:
The transplant candidate must first be referred for kidney transplant evaluation by their kidney doctor. The potential donor can then contact the living donation program nearest to where they live to let them know they are interested in donating a kidney to that person. Both the potential donor and the transplant candidate must complete medical tests and evaluations to ensure they are healthy enough to have the surgeries.
Sometimes, the potential donor’s blood and/or tissue type does not match the transplant candidate’s blood and/or tissue type. In this case, the donation and transplant cannot be done because the transplant candidate’s body will reject the kidney.
A potential donor and transplant candidate in this situation are called an “incompatible pair.” Even though they are not a match with each other, incompatible pairs can consider taking part in a donor swap by enrolling in the Kidney Paired Donation program. A donor swap can include two or more pairs. Each donor donates a kidney and every transplant candidate receives a kidney.

How do I get started?
If you know a person who is waiting for a kidney transplant, you can talk to them. Or, you can contact a living donation program in your province. If you would like to become a non-directed anonymous donor a living donation program in your province can give you more information.
The Living Donor Services Program – Edmonton
Phone: 780-407-8698 | Toll free: 1-866-253-6833
Email: [email protected]

Information taken from Canadian Blood Services Site

02/24/2026

Hello! It has been quite awhile and I wanted to give an update on how things are.

In mid-November I started dialysis, gradually switching to using a cycler machine. The dialysis itself is going okay, but my body is having a real difficult time adjusting to it.
Since December I have been experiencing being lightheaded and dizzy, having weakness in my arms and legs and being even more tired than I was before. These symptoms have continued to get worse to the point where if I stood up for over a minute or two I would throw up.
Speaking to my nephrology team and also visiting my family doctor revealed that my electrolytes were very low, as was my blood pressure. I was also dehydrated from the amount of fluid being pulled during dialysis.
I have since been eating to try and raise my potassium and sodium levels and also trying to adjust my dialysate strengths to also help with the electrolytes and blood pressure.
After having another rough day today, I know that I have not yet gotten this figured out, so I need to keep trying to balance things.
I have spent the last two months essentially not being able to do anything and it is beginning to wear on me some days. I have hardly been out of the house and when I have been a lot of the time I am on the cusp of either throwing up or blacking out. Not a fun situation to be in.
Anyhow, I persevere.
I am still looking for that perfect donor match. Please consider being a donor and please share this so that my perfect match might see it.

Thank you. 💜