Stanford Impact Labs Invests in Global Collaboration to Increase Access to Kidney Transplants

Stanford Impact Labs (SIL) is delighted to announce a $1.5 million Stage 3: Amplify Impact investment to support Extending Kidney Exchange, a solutions-focused project established to increase access to lifesaving kidney transplants.

The team, led by Stanford’s Dr. Alvin (Al) Roth, who shared the 2012 Nobel Prize in Economics for his work on market design, and the Alliance for Paired Kidney Donation (APKD) is working in close partnership with organ transplant specialists and medical centers in Brazil, India, and the U.S., including Santa Casa de Misericórdia de Juiz de Fora, the Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation Sciences (IKDRC-ITS), and Walter Reed National Military Medical Center.

Over the course of the next three years, the team aims to increase the number of transplant opportunities available to patients who need them by creating and growing kidney exchange programs in Brazil and India, where millions of people suffer from kidney disease yet exchange is minimal; and explore the effects of initiating donor chains with a deceased donor kidney (DDIC) in the U.S., an approach which could unlock hundreds more transplants each year.

Building Capacity in Brazil and India

In Brazil, the team has launched a kidney exchange program within two academic centers (Santa Casa de Misericórdia de Juiz de Fora and Hospital Clínicas FMUSP in São Paulo) as a research project and hopes to produce proof of concept that will help expand the program to include other centers and eventually lead to policy change. 

​​In India, the team is working with transplant centers already using APKD’s software, as well as with national and state agencies and their corresponding transplant centers to launch new kidney exchange programs. The team is building the capacity for transplant centers to work together to achieve local, regional, and national kidney exchange powered by Professor Roth and team’s Nobel Prize-winning algorithm. A goal of the project is to demonstrate a working model to support kidney exchange programs nationwide and develop an evidence base for potential updates to organ transplantation laws that expand criteria for who can give and receive lifesaving kidneys.

Testing Deceased Donor-Initiated Chains in the U.S.

As it stands today in the U.S., a kidney from a deceased donor that is allocated through the Organ Procurement and Transplantation Network (OPTN) cannot legally start a chain; it must be given to a single person on a transplant waitlist. As one measure of what could become possible in the face of the mounting need for kidney transplants, research found that allocating just 3% of existing deceased donor kidneys to chains could generate up to 290 additional life-saving transplants each year that wouldn’t have otherwise occurred.

Working in partnership with Life Connection of Ohio, a federally designated organ procurement organization, and the Walter Reed National Military Medical Center, which falls under regulations that permit the intervention to take place through a program known as “Military Share”, the team aims to save additional lives by creating an evidence base for the use of deceased donor-initiated chains (DDIC). 

The Path from Science to Impact

In addition to saving more lives through transplants, project goals include the development of: (1) a kidney exchange roadmap applicable to many more countries; and (2) data and evidence as to how particular market mechanisms – i.e. kidney matching software that recommends combinations of transplants – interact with medical, regulatory, and social constraints. 

The team also seeks to learn: (1) how demonstrations of successful interventions can be used to prompt needed interventions in legislation and regulation, and (2) how kidney transplantation can be adapted to local constraints, i.e. in resource-restricted countries that do not currently support non-directed donation.

Established as a special initiative within Stanford’s School of Humanities and Sciences to accelerate closing the gap between social science research and scalable public impact, Stanford Impact Labs (SIL) invests in a portfolio of solutions-focused projects like Extending Kidney Exchange that are both impact-driven and partnership-based. Stage 3 funding provides long-term, flexible support to established teams able to demonstrate a track record of successful partnership-based research and development (R&D) cycles.