When your donor isn't a match, swap
KEPSA is South Africa's national kidney exchange. It pairs patients whose donor is incompatible with others in the same position, so each patient gets a kidney from another pair's donor.
Built on Groote Schuur Hospital's paired donation programme, with the Department of Health and the Ministerial Advisory Committee on Transplantation.
How a swap works
A daughter wants to give her mother a kidney, but their blood groups don't match. Elsewhere, a father wants to donate to his son and can't either.
If the daughter matches the son and the father matches the mother, the two families swap donors. Both patients still get a kidney given out of love, just from someone else.
KEPSA finds these swaps across transplant centres, public and private, and can link three or more pairs in a chain.
For patients and donors
You join KEPSA through your nephrologist or transplant coordinator, and you can withdraw at any time without giving a reason.
- It costs you nothing
- Tests and surgery are usually covered by the province or your medical aid. Transport and time off work aren't.
- Matches are checked often
- KEPSA searches for matches at least every three months. You stay on the deceased-donor waiting list until one is confirmed.
- Donors have surgery together
- Every donor in an exchange is operated on at the same time, so nobody can withdraw after another has donated.
- Your identity stays private
- Donors aren't told who receives their kidney. Recipients only learn medical details, such as the donor's age and kidney function.
For clinicians
Nephrologists and transplant coordinators enter pairs for their patients. A coordinator checks every pair before it goes into the matching pool.
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Enter the pair
Submit donor and recipient details with their HLA typing.
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Coordinator review
A coordinator checks the entry against the lab results.
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Match run
The algorithm looks for exchange cycles and chains.
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Sign-off
The nephrologist and coordinator confirm the match.
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Transplant
After a final crossmatch, donor surgeries are scheduled together.
Before you enter a pair
- Your team has ruled out every other living-donor option.
- MACOT has approved the pair as medically fit, even if they're related.
- Blood group and HLA typing at A, B, DR and DQ are on file.
- The recipient has HLA antibody results under six months old from an accredited lab.
- Donor and recipient have both signed the KEPSA consent forms.
The platform
Clinicians manage their pairs and follow every match run at kepsa.save7.org.
Dashboard
Recipients, pairs and completed transplants across every centre.
Match runs
Each run's pool size, the cycles and chains it found, and what came of them.
Register your centre
Tell us who you are and where you work, and we'll set up your access.