Introduction: Paired exchange kidney donation has become an important tool for overcoming the barriers faced by the patients with end-stage renal disease where the living potential donors who are willing to donate to them are found to be unsuitable as donors for them due to an incompatibility of blood type, of HLA cross-match, or of both. In case of Paired kidney Donation, the problem of the donor recipient pairs can be solved by exchanging donors, which increases the donor pool by substantial numbers. In India there has been an upward trend in the paired exchange kidney donation in last few years. Here we report our results with the living donor exchange program (largest in northern India) since its inception at our institute.
Methods: Paired exchange kidney transplant done between in 2014 to march 2024 were taken, a total number of 127 recipients included. Their baseline characteristics were analysed, cause of end stage renal disease, reason for swap transplant, follow up after renal transplant along with donor characteristics.
Results: The mean recipient age was found to be 40 years with 81 % being male recipients. The mean donor age was found to be 47 years of age   with 80 % being female recipients. 94 % recipient underwent Paired exchange kidney transplant in view of ABO incompatibility. Average waiting time for Paired kidney match after enrolment was 1 month. Chronic glomerulonephritis was suspected to be the dominating cause of end-stage renal disease in these recipients. Serum creatinine was 1, 1.4 and 1.5 mg/dl at discharge ,1 year and 3 years respectively
Conclusion: In the recent trends paired kidney donation transplantation has become a important viable procedure medically and economically to fulfil the ever increasing demand for renal donor for transplant. An excellent graft outcome is shown in our study which supports paired kidney donation transplantation, as in turn it can be promoted to intercity , regional and subsequently national transplant centre with high number of incompatible related donor and low deceased donor transplant program.