Who should travel in kidney exchange programs: the donor, or the organ?

In 2009 the Canadian Blood services launched the Living Donor Paired Exchange Registry. This program circumvents the obstacle presented by blood-group or immunologic incompatibility between a living potential donor and his or her intended recipient. At the beginning, only 3 provinces joined the program, but as of October 2010 all Canadian provinces are participants. Up to now, participating donors have travelled to recipients’ transplant centres. We might question whether, in a country such as Canada, the donor or the organ should travel. In this article, we review the arguments for donor travel and the arguments for shipping the kidney.