Kidney Paired Donation (KPD) Program

Canadian Blood Services operates the national Kidney Paired Donation (KPD) program, formerly the Living Donor Paired Exchange (LDPE), an interprovincial program that is operated by Canadian Blood Services in collaboration with Canada’s living kidney donation and kidney transplant programs. The KPD program gives living individuals an opportunity to donate, and recipients an increased opportunity to find a match.

Kidney Paired Donation Program Results

Any adult who is in general good health can be assessed to become a living kidney donor. If the donor wishes to donate to a friend or family member (a transplant candidate), medical assessments are conducted to determine whether the donor is a suitable match for the recipient. With a compatible match, the directed donation can proceed through the provincial program.

If the donor is not a match for their friend or family member, they may be able to help the transplant candidate find a matching donor through the KPD program.

Match Cycle (MC) Activity

Once the provincial transplant program assesses and qualifies the donor as eligible to donate through KPD, the donor must consent to having their data entered in the Canadian Transplant Registry (CTR) and agree to being listed. Only then does the provincial program enter the donor’s medical information into the Canadian Transplant Registry, a secure computer database managed by Canadian Blood Services. The donor and their specific friend or family member who requires a kidney transplant are  “paired.”

When an individual donor does not have a specific friend or family member to pair with but wishes to donate to anyone who needs a kidney transplant, they must be assessed for donation and cleared to enter the KPD Program as a non-directed anonymous donor (NDAD).

KPD Registered Candidates, Transplant Recipients, and NDADs by PHN Province 


All donors have the choice to proceed or withdraw from the process at any time and those wishes are always honoured. All the pairs and non-directed anonymous donors in the registry are run through a sophisticated matching program to identify potential donor matches that can form pairings or “chains” of donor kidney exchanges. The matching program seeks to match the recipients with a kidney donor for a transplant. 

Learn more about how it works

A complex matching algorithm is run approximately once every three months which compares the medical information on all the pairs and non-directed donors in the registry and identifies kidney transplant opportunities.

Upon further medical review, each kidney exchange is completed in one of the following three ways:

1) Paired Exchange
Let’s say Donor A wishes to donate a kidney to Recipient A, but they are not a match. Donor B would like to donate a kidney to Recipient B, but they are not a match.  However, Donor A is a match with Recipient B and Donor B is a match with Recipient A. A paired exchange is then completed.

2) N-Way Exchange
An n-way exchange is similar to a paired exchange, except there are more pairs included and the donor of the last pair donates to the recipient of the first pair.

3) Domino Exchange
Domino exchanges begin with a non-directed donor who donates to the recipient of an incompatible pair. There can be multiple incompatible pairs in a domino exchange as you can see below with pairs A, B and C.
The exchange is complete when the donor of the last incompatible registered pair donates to a recipient on the transplant waitlist who is from the same transplant program as the non-directed donor.

See the KPD Program results to date. By being in the registry, the computer system can identify these matches so doctors can determine if it is possible to exchange donors.

Power of one—the non-directed anonymous donor

The fact that domino exchanges create significant transplant possibilities, was quickly realized when the KPD program was first launched. When a non-directed donor — a person who is not paired with a recipient, but wishes to donate a kidney to anyone in need — enters the KPD program, their kidney donation is not conditional on a friend or family member receiving a transplant in return. This gives them a greater possibility of being matched and helping others fit into a chain of exchanges — a domino chain.

Non-directed donors greatly increase the number of available matches. This selfless act of giving by non-directed donors has meant that…

Since they enter as a single rather than a pair, it also means that at the end of the domino exchange, one patient on the deceased donor waiting list from the same transplant program also gets a kidney.

For a list of all Canadian living kidney donation programs, please click here.


For more information about living kidney donation, download the following brochures:

What is Living Kidney Paired Donation
Kidney Paired Donation (KPD) Program

Requests for brochures can be made by calling our Customer Support team at 1-855-274-2889 or by emailing