Kidney exchange transplant pilot program launched between the United States and Italy

TOLEDO, Ohio–(BUSINESS WIRE)–The Alliance for Paired Kidney Donation (APKD), an Ohio-based nonprofit organization that operates an international kidney exchange registry, today announces the launch of a pilot exchange program kidney disease between the United States and Italy. The signing of the agreement between the APKD and the Centro Nazionali Trapianti (CNT), the organization that manages all transplant activities in Italy, enables the first-ever exchange of kidneys from living donors between Europe and the United States. United.

The purpose of the memorandum of understanding, which was signed at the Ministry of Health in Rome, is to provide for the possible treatment of thousands of patients awaiting kidney transplants in the United States and Italy. The agreement was signed on behalf of CNT by its director, Massimo Cardillo, and by Michael A. Rees, MD, PhD, CEO of APKD and Surgical Director of Kidney Transplantation at the University of Toledo Medical Center in the United States. ‘Ohio.

The new US-Italian program involves kidney exchange transplantation, in which incompatible living donor and recipient pairs are matched with other incompatible pairs for kidney transplants. Thanks to the agreement between the APKD and the CNT, incompatible US and Italian donor-recipient couples will be able to exchange with each other based on a shared algorithm that will check the level of compatibility between those on the waiting lists. registry of countries. In this way, patients with kidney failure, who also have an incompatible voluntary donor, will have a better chance of receiving the transplant they need.

In addition to the technical-operational aspects – such as the requirements of the participating hospitals, the matching algorithm and the overall governance of the transplant process – the agreement provides that the costs related to the transplant procedure are covered by the cover US insurance for the US receiver. and the Italian donor, while the Italian national health service will cover the expenses of the Italian recipient and the American donor. Transplant surgeries will take place in the country where the recipient is located.

The pilot phase of the program will cover the first three cases and will be limited to one hospital in Italy, while in the United States, selected APKD partner transplant centers will be accepted into the program with the approval of the CNT. Once the initial operational and management process is completed, the program will be reassessed for possible consolidation of the protocol and gradual expansion to other living kidney transplant centers in the Italian and APKD networks.

The deal with Italy is the latest example of APKD’s global leadership in kidney swapping. In late 2021, the organization also helped coordinate a landmark series of donor-to-patient kidney transplants in Israel and the United Arab Emirates that saved the lives of three women.

Today in the United States, approximately 20% of the 6,000 living donor kidney transplants are performed by kidney exchange. The APKD believes that the collaboration between its organization and the CNT could significantly increase the number of kidney transplants from living donors performed for Italian and American citizens suffering from kidney failure.

“The kidney swap helps us celebrate our differences — for the benefits they provide,” said Rees, CEO of APKD. “Larger pools provide more opportunities for kidney swapping for mismatched pairs in those pools. But an often overlooked aspect of kidney swapping is that patients with antibodies that prevent their donors from donating are often products against common targets within their ethnicity or population Kidney exchange shows us how our differences can be the critical element, allowing us to help each other by providing donors who do not have the targets of these antibody.

Rees goes on to note that, “We believe that the heterogeneous American population will give homogeneous Italian patients a much better chance of finding a match than working with similar populations in southern Europe.”

This kidney exchange program with the United States is the second international exchange program launched by Italy. Since 2018, Italy has had an agreement between France, Portugal and Spain, which has resulted in three kidney exchange transplants with the latter nation.

“Living kidney transplants are an effective treatment option for recipients and absolutely safe for donors, but to date they represent less than 17% of kidney transplants performed each year in Italy,” said Cardillo, director of the CNT. “This is a rapidly growing percentage but still insufficient to meet the many patients who are still waiting. This agreement between Italy and the United States literally opens a new frontier and will allow us to significantly increase the chances of establishing positive matches between different patients.

The end goal, Cardillo continues, is an international paired-exchange kidney transplant network. “From this experience, we can work towards a cooperation agreement between all European countries that will allow us to internationalize kidney exchange programs for the benefit of all patients.”

CNT’s full announcement, including a response from Italy’s Undersecretary of Health Pierpaolo Sileri, is available on CNT’s website.

To learn more about the APKD and its industry-leading kidney registry, visit

About the Alliance for Paired Kidney Donation

The Alliance for Paired Kidney Donation (APKD) is a global 501c3 that runs a kidney registry powered by a Nobel Prize-winning algorithm. The APKD has revolutionized kidney donation by achieving the world’s first non-concurrent altruistic donor chain and the first international chain. APKD’s commitment to innovation, research, education, technology and generosity enables it to fulfill its mission to save lives by ensuring a living donor kidney transplant for every patient in need.

Centro Nazionali Trapianti (CNT):

Centro Nazionali Trapianti (CNT), created under Law 91/1999, is located at the Istituto Superiore di Sanità (ISS), as a department. It coordinates all activities relating to the donation, allocation and transplantation of organs; tissue donation, banking and transplantation and patient waiting lists. It manages the transplant information system, collects data on organ donation, allocation and transplantation, including the quality of transplanted organs, and defines protocols on the safety and security of organ donation. organs and criteria for operational protocols for organ and tissue allocation, organ allocation for emergencies and national programs. It sets the parameters for evaluating the quality of transplants, promotes public information campaigns, in collaboration with the Ministry of Health and patient associations, promotes and develops training on organ donation. ISS and CNT have extensive experience in participating and coordinating projects. During these years, the international activity of the CNT has evolved, focusing on international relations, EU-funded projects, cooperation agreements with the EU and Mediterranean countries; international organ exchanges via the Italian Gateway to Europe in partnership with CIR OCST and Policlinico Umberto I; and monitoring Italian patients abroad and foreign patients in Italy.