HOW THE UK SHARING SCHEME WORKS

Swap the kidney,
keep the promise.

Some donors cannot give to the person they came for.

Blood group or tissue type can rule a match out. In the UK Living Kidney Sharing Scheme, that pair can join others in the same position, and each donor gives to someone else's partner, relative or friend.

2 OR 3 PAIRS in one swap

Find the route

Four adults seen from behind walking in two pairs along a bright, quiet hospital corridor — AI-generated image, not a photograph of a real person or place.

Register as a pair
Match four times a year
Swap between pairs
Every donor still helps their own person

THE SHORT ANSWER

When a pair can't match,
pairs can swap.

NHS Blood and Transplant runs the matching.
Each swap involves two or three pairs.

TRANSPLANT CYCLES

Two or three pairs swap

Donor 1 gives to recipient 2 while donor 2 gives to recipient 1. A three-way cycle adds a third pair to close the loop.

Find the route

THE KIDNEYS TRAVEL

Operations at home

Operations are usually planned at the same time, and the kidneys are transported between hospitals, so people can stay at their own transplant centre.

How a swap runs

MATCHING

Blood group and tissue type

Pairs may be incompatible because of blood group or HLA tissue type. Every matching run looks for the best combinations across everyone registered.

See the numbers

General information only, not medical advice. For advice about your own health, speak to a doctor, pharmacist or other qualified health professional.

A QUICK ROUTE CHECK

Which kind of
living donation?

Pick a situation to see which type of living kidney donation the Human Tissue Authority and NHS Blood and Transplant describe for it. The bar shows how much national matching is involved.

Route check

Choose a situationCompatible with a relative or friendCompatible, but hoping for a better matchNot compatible with each otherWants to give to a stranger

Compatible with a relative or friendDirected donation

A donor gives to a specific person they have a genetic or pre-existing emotional relationship with, such as a parent, sibling or friend.

Compatible, but hoping for a better matchCan join the scheme

NHS Blood and Transplant says compatible pairs can also register in the sharing scheme to seek a better match.

Not compatible with each otherPaired or pooled

The pair registers in the scheme and may be matched into a two-way (paired) or three-way (pooled) swap with other pairs.

Wants to give to a strangerAltruistic chain

A non-directed altruistic donor gives to an unknown recipient. Their kidney can start a chain of transplants that ends with someone on the national waiting list.

Sources: Human Tissue Authority, Types of living organ donation; NHS Blood and Transplant, UK Living Kidney Sharing Scheme.

Based on Human Tissue Authority and NHS Blood and Transplant descriptions. Suitability is always decided by a transplant centre; this is not medical advice.

TWO NUMBERS WORTH KNOWING

A national scheme,
matched in rounds.

One figure on what the scheme has done,
one on how often it looks for matches.

1,839

Through the sharing schemes, May 2007 to Aug 2023

In the same period 3,581 donor and recipient pairs were registered, and 551 altruistic donors took part in matching runs.

TRANSPLANTS · NHSBT

4× a year

How often pairs are matched

NHS Blood and Transplant runs a matching run every three months to find the best transplant cycles and chains across everyone registered.

MATCHING RUNS · NHSBT

NHSBT's records for a single matching run were set in April 2019: 313 pairs included, 97 transplants identified and 72 that went ahead.

HOW A SWAP RUNS

From registration
to transplant.

Kidney Care UK and NHS Blood and Transplant describe the same basic steps.

Assessment as a pair
The local transplant centre assesses whether the donor and recipient can be put forward to the national scheme.
The matching run
Four times a year, NHSBT looks for the best combination of transplants across all registered pairs and altruistic donors.
Compatibility testing
If chosen, the pairs are tested to make sure the kidneys are compatible before anything is arranged.
Operations and travel
Operations usually happen at the local transplant centre, at the same time or sometimes staggered, and the kidneys travel.

Gloved hands lifting a blood sample tube from a rack of tubes in a laboratory — AI-generated image, not a photograph of a real person or place.

A plain blue medical transport cool box on a trolley in a hospital corridor — AI-generated image, not a photograph of a real person or place.

CHAINS

One stranger's gift,
several transplants.

When someone donates to a person they have never met, NHSBT can use that kidney to start a chain. It goes to a recipient in the scheme, whose own donor then gives to the next person.

A chain ends with a kidney for someone on the national waiting list. If there is a high-priority recipient on that list, NHSBT says a non-directed altruistic kidney is offered to them first.

Questions

Questions people ask

What is paired and pooled kidney donation?

Donor and recipient pairs who are incompatible, or who want a better match, swap kidneys with other pairs. Two pairs is paired donation; more than two is pooled donation.

Why might a donor not match their own recipient?

NHS Blood and Transplant says pairs may be unable to donate to each other because of incompatible Human Leucocyte Antigen (HLA) tissue types or blood groups.

How often does matching happen?

NHS Blood and Transplant runs a living donor kidney matching run four times a year, every three months.

Is it only for kidneys?

Yes. The Human Tissue Authority says paired and pooled donation is currently only available for kidney transplants in the UK.

Who approves living donation?

After medical assessment, a Human Tissue Authority Independent Assessor interviews the donor to check the Human Tissue Act 2004 has been met, and the HTA makes the decision.

Swap the kidney,
keep the promise.