For both kidney and simultaneous kidney-pancreas (SKP) transplants, two types of donors exist:
- Living donor
- Deceased donor
In either case, the donor has to be a match with you.
For living donors, the best results are usually a closely matched kidney from a living donor (usually a sibling). The next best results are seen with a kidney from a less closely matched living donor (such as a spouse or friend).
For SKP transplants, the best results are usually seen when both the pancreas and a kidney come from the same deceased donor as the risk of rejection is significantly reduced.
How is a match determined?
Three main tests are completed to determine if a patient and a potential donor are a kidney match: blood typing, tissue typing and cross-matching. Blood type matches are the first test to be completed, and the recipient and donor must be a match in order to proceed.
Below is a chart identifying to whom a donor may be a match based on the blood types of both parties.
| Donor Blood Type | Potential Recipient Blood Type Matches |
| A | Blood types A and AB |
| B | Blood types B and AB |
| AB | Blood types A, B and AB |
| O | Any blood type; blood type O is the “universal donor” |
The chart below shows from whom a transplant recipient may receive a kidney.
| Recipient Blood Type | Donor Blood Type(s) |
| A | Blood types A and O |
| B | Blood types B and O |
| AB | Any blood type; blood type AB is the “universal recipient” |
| O | Blood type O |
If the donor’s blood type is a match, the tissue typing and cross-matching tests will be conducted.
Tissue typing (HLA match) is not as straightforward as each person’s tissues are generally different from everyone else’s, except in the case of identical twins. The common school of thought is the better the HLA match, the more successful the transplant will be in the long term.
The best HLA matches are generally between a parent and child- at least a 50 percent chance of matching. Matches between siblings can vary from zero to 100 percent, and unrelated donors would be the least likely match. Matches are based on 12 markers, and a 12 out of 12 match (zero mismatch) is possible for a patient with a very common HLA type, even with an unrelated, deceased donor.