A paired kidney donation is becoming increasing popular as a way to overcome an incompatibility between a kidney donor and a transplant recipient. It usually involves finding two couples with incompatibility issues where the donor of first couple is willing donate to the recipient of second couple – and visa versa. Medically, this approach has worked very well since it was first introduced in 2001. However, the problem is that, many transplant centers worry that it might violate National Organ Transplant Act (NOTA). In response to this concern, Congress has recently introduced the Living Kidney Organ Donation Clarification Act (S-487 and HR-710) to clarify that kidney paired donations shall not be considered to involve the “transfer of a human organ for valuable consideration”. If signed into law, this act will remove a serious impediment to living kidney organ donation.

There are over 70,000 people waiting for a kidney transplant in the United States alone. Although most people undergoing kidney transplantation receive their kidney from someone who died (cadaveric transplant), the rate of live kidney donation is increasing rapidly (living related). In addition to decreasing the wait time, undergoing a living related transplant usually lead to better short-term and long-term results. In most cases of live donations, the donor and the recipient have a relationship (i.e. husband and wife, parent and child, etc). Sometimes, it is not medically possible to donate a kidney to a specific person. It is currently unethical and unlawful to buy a kidney or to receive “valuable consideration” in return.

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