{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T13:03:57Z","timestamp":1766754237197,"version":"3.48.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Kidney paired donation (KPD) programs are organized in various countries to facilitate the donation of kidneys from willing but incompatible donors by matching them with pairs in similar situations. These programs often struggle with an accumulation of difficult-to-match recipients and small pools of incompatible pairs. To address this, several international collaborations have emerged to expand the pool sizes and increase the number of transplants by \u201cexchanging\u201d donors\u2019 kidneys across countries. We identified 4 established international KPD programs, each supported by protocols and agreements signed by the participating parties. Each program is presented separately, detailing its historical establishment, operational aspects, and statistics on pool characteristics and performance. Following this, we provide a comparative analysis of key aspects across the 4 programs. Each program has its unique context and specificities. Even though 3 of 4 collaborations started just before the COVID-19 pandemic, they have collectively facilitated &gt;450 transplants. This underscores the importance of further developing these collaborations to share practices and experiences, and to facilitate more transplants, particularly for difficult-to-match recipients. Three of the 4 presented collaborations are either fully operated or led by European countries. This highlights the crucial role of ongoing international cooperation in the development of KPDs, in particular in Europe. By further promoting collaboration among countries, we can facilitate pan-European exchanges and improve access to live kidney transplants for patients in need.<\/jats:p>","DOI":"10.1097\/tp.0000000000005602","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T15:00:07Z","timestamp":1766588407000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["International Kidney Paired Donation Programs: Evolution and Practices of 4 Large Collaborations"],"prefix":"10.1097","author":[{"given":"Xenia","family":"Klimentova","sequence":"first","affiliation":[{"name":"INESC TEC: Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal."}]},{"given":"Beatriz","family":"Dom\u00ednguez-Gil","sequence":"additional","affiliation":[{"name":"Organizaci\u00f3n Nacional de Trasplantes, Madrid, Spain."}]},{"given":"Ana","family":"Viana","sequence":"additional","affiliation":[{"name":"INESC TEC: Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal."},{"name":"Polytechnic of Porto, School of Engineering, Porto, Portugal."}]},{"given":"David","family":"Manlove","sequence":"additional","affiliation":[{"name":"School of Computing Science, University of Glasgow, Glasgow, United Kingdom."}]},{"given":"Tommy","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Economics, Lund University, Lund, Sweden."}]},{"given":"Tamar","family":"Ashkenazi","sequence":"additional","affiliation":[{"name":"Israel Transplant Organization, Ministry of Health, Jerusalem, Israel."}]},{"given":"Gabriela","family":"Berlakovich","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Medical University of Vienna, Vienna, Austria."}]},{"given":"Georg A.","family":"B\u00f6hmig","sequence":"additional","affiliation":[{"name":"Department of Medicine III, Medical University of Vienna, Vienna, Austria."}]},{"given":"Jo","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Auckland City Hospital, Te Toka Tumai, Te Whatu Ora, Auckland, New Zealand."}]},{"given":"Elisabeth","family":"Coll","sequence":"additional","affiliation":[{"name":"Organizaci\u00f3n Nacional de Trasplantes, Madrid, Spain."}]},{"given":"Ian","family":"Dittmer","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Auckland City Hospital, Te Toka Tumai, Te Whatu Ora, Auckland, New Zealand."}]},{"given":"Pamela","family":"Fiaschetti","sequence":"additional","affiliation":[{"name":"Centro Nazionale dei Trapianti, Rome, Italy."}]},{"given":"Jiri","family":"Fronek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic."}]},{"given":"Peter D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Royal Melbourne Hospital, Melbourne, VIC, Australia."},{"name":"Department of Medicine, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, VIC, Australia."}]},{"given":"Margarida","family":"Ivo da Silva","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas do Sangue e da Transplanta\u00e7\u00e3o, Lisbon, Portugal."}]},{"given":"Eytan","family":"Mor","sequence":"additional","affiliation":[{"name":"Sheba Medical Center, Tel Aviv, Israel."}]},{"given":"Ond\u0159ej","family":"Viklick\u00fd","sequence":"additional","affiliation":[{"name":"Transplant Centre, Department of Nephrology Institute for Clinical and Experimental Medicine, Prague, Czech Republic."}]},{"given":"Ilse Duus","family":"Weinreich","sequence":"additional","affiliation":[{"name":"Scandiatransplant Office, Aarhus, Denmark."}]},{"given":"Paolo","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ospedale Civico Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland."},{"name":"University of New South Wales, Sydney, NSW, Australia."}]}],"member":"276","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"R1-20251226","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.","volume":"341","author":"Wolfe","year":"1999","journal-title":"N Engl J Med"},{"key":"R2-20251226","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1097\/00007890-200211270-00005","article-title":"Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomes: a paired donor kidney 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