Altruistic Donation


Non-directed altruistic donation (NDAD) - a person donates to a recipient on the national transplant list whom they have never met or previously heard about.

Directed altruistic donation (DAD) - a person donates to a recipient with whom they have

  • A genetic relationship but no established emotional relationship
  • No pre-existing relationship prior to the identification of the recipient's need for a transplant
Directed altruistic donation is not included within the National Living Donor Kidney Sharing Schemes (NLDKSS) because the donation is directed towards a specific individual.

Summary of Arrangements for Non-Directed Altruistic Donation (NDAD) Donating to National Transplant List

Donor assessment and preparation for donation as per UK Guidelines and local transplant centre protocol, including mental health assessment. See the British Transplantation Society Standards and Guidelines.
Human Tissue Authority (HTA) approval process via local Independent Assessor and HTA panel.
Donor has the opportunity to 'opt-in' to Altruistic Donor Chain (ADC) or 'opt-out' and donate directly to the national transplant list and is registered with Organ Donation and Transplantation (ODT), NHS Blood and Transplant (NHSBT).
Opt-out of ADC Matching run performed for allocation to national transplant list as for deceased donor kidneys.
Once recipient has been identified, special considerations relating to donor +/- kidney that are relevant to the acceptance of a donor kidney by the recipient centre circulated by ODT to named LDC contact, who reports decision of clinical team back to ODT.
Compatibility is confirmed between NDAD and the recipient on the national transplant list by performing crossmatch testing (ideally within 7-14 days). Suspension of the recipient from the transplant waiting list at the discretion of the recipient and recipient transplant centre.
For suitable donor-recipient pairs
  • Date of surgery scheduled between centres. Anonymity as for PPD.
  • Final crossmatch tests according to agreed protocol prior to scheduled date of surgery.
  • Suitable storage and transport of kidneys arranged by named LDC contacts in transplant centres.
If the transplant cannot proceed
  • Depending upon the reason, consider re-allocating the kidney to a different recipient to avoid delay to the donor or wait until it is possible to proceed if timeframe is realistic for all parties.

Relevant patient associations and charities can be found in Useful Links
Next section: Domino Kidney Donation

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