Skip to main content

Explainer: What Are Kidney Donor Chains?

In donor chains, the “ties that bind” inspire friends and family to donate a kidney to a stranger so that, in return, their loved one receives a kidney transplant, too.

connected paper dolls with a heart between them to illustrate kidney transplant chains

The story made headlines and it’s easy to see why: In a highly choreographed swap, five healthy people each gave a donated kidney to five strangers desperately in need.

The five donors and five recipients in Houston, Texas, were part of a kidney donor chain – an innovation in the way kidney transplants can be structured. It’s challenging enough to arrange a single kidney transplant, a complex, high-stakes surgery that can save a person’s life. Now imagine setting up a kidney donor chain, which allows multiple organ donors to give a kidney to a stranger so that their loved one also gets a kidney in the bargain.

Read about the surgeries, which occurred over three days at Houston Methodist Hospital.

You’ve probably seen Facebook posts and even billboards that plead for people to get tested to see if they are a “match” for someone who desperately needs a kidney transplant. Transplant organs are in short supply and people often wait on long lists to receive one while their friends and family wonder how they can possibly help.

The most generous might offer to donate a kidney themselves, but not everyone will be a match, even if they are related. Someone is only suited to donate a kidney to another person after a series of blood tests to check blood typing, tissue typing and cross matching, according to the National Kidney Foundation. Donors also can’t have uncontrolled high blood pressure, diabetes, cancer or other serious conditions.

The demand for donated organs vastly exceeds the supply. In the United States in 2021, more than 90,000 people were waiting for donated kidneys and only 24,670 received them, according to After receiving an organ transplant, recipients must follow strict guidelines while recovering and are closely monitored for signs their body is rejecting the donated organ. According to Columbia Surgery, 10% to 20% of kidney transplant recipients will experience at least one episode of rejection.

CSL Behring, a global biotech leader, is investigating a potential treatment to preserve the precious gift of a donated kidney. In June 2020, CSL Behring acquired a company developing a monoclonal antibody with the potential to combat the leading cause of long-term rejection in kidney transplant recipients: chronic active antibody-mediated rejection (AMR). The potential treatment is an anti-IL-6 monoclonal antibody, currently in Phase III development.