The National Kidney Registry (NKR) released its 2025 Outcomes Report, revealing improved outcomes for NKR-facilitated transplants. The improved outcomes were driven by precision eplet matching and better matches for sensitized patients. Matching strategies employed by the NKR reduce de novo DSA formation, reduce graft failure, provide an opportunity for lower immunosuppression, and increase the longevity of a transplanted kidney.
Sensitized patients (> 80% cPRA) experienced a 38% lower 3-year death-censored graft failure rate compared to non-NKR transplant recipients. This data reinforces that all highly sensitized end-stage kidney disease (ESKD) patients should consider participating in an NKR swap to find a well-matched donor through the NKR.
Unsensitized patients who received a low eplet mismatched donor through an NKR-facilitated swap had a significantly lower rate of de novo DSA formation—a key precursor to rejection and graft failure. Unsensitized patients who received medium/high eplet mismatched donors had a 538% higher hazard of de novo DSA formation in the first 3 years post-transplant. This indicates that all ESKD patients with a compatible donor should consider participating in an NKR swap to improve their donor match, reducing their risk of de novo DSA and premature graft failure.
“As a transplant community, we’ve always sought to improve the identification of donors best immunologically ‘matched’ to our recipients that would translate to improved longevity and the opportunity to reduce the toxicities associated with standard immunosuppression through medication minimization,” said Dr. Matthew Cooper, NKR Surgical Director. “We now have that data! We now owe it to our patients, regardless of standard compatibility, to take advantage of the NKR’s eplet matching for all donor and recipient pairs that come to transplant programs expecting us to utilize the best tools and technology to optimize their outcomes.”
“These outcomes demonstrate that paired exchange has gone far beyond facilitating transplants for patients with incompatible donors. We are now improving the donor-recipient match, which can dramatically improve outcomes for patients with compatible direct donors. The result is a living donor kidney transplant that lasts longer and provides an opportunity to reduce immunosuppression,” said Garet Hil, NKR Founder and CEO.
For more information or to access the full 2025 Outcomes Report, visit the NKR website.
About the National Kidney Registry
The National Kidney Registry (www.kidneyregistry.com) is an organization whose mission is to save and improve the lives of people facing kidney failure by increasing the quality, speed, and number of living donor transplants while protecting
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