2 min readBengaluruApr 6, 2026 03:29 PM ISTMulti-pair kidney swapping works by linking three or more donor-recipient pairs into a group. (Representational image)In a significant move that could help patients awaiting a kidney transplant, the Karnataka Government has issued guidelines permitting multi-pair kidney paired swap transplantation. This will expand the scope of organ donation beyond the traditional two-way system.The Karnataka Multi-Pair Kidney Exchange Transplantation Guidelines 2026 were issued via a government order on April 4.“A significant number of donor-recipient pairs in Karnataka are unable to undergo transplantation on account of biological incompatibility… Applications have been received from registered transplant hospitals in Karnataka seeking approval for multi-pair Kidney Paired Exchange Transplantation involving three or more donor-recipient pairs,” the order said.Until now, under the Transplantation of Human Organs and Tissues Act (THOTA) 1994, swap donations were limited to two incompatible donor-recipient pairs. Each donor had to be a near relative of their intended recipient, and the swap was confined to a simple two-way exchange. This left many patients unable to undergo transplantation due to incompatibilities such as ABO blood group mismatch and others.Swap donation means that when two families each have a donor and a recipient, but the donor is biologically incompatible with their own relative, the donor from one family gives a kidney to the recipient in the second family, and the donor from the second family gives a kidney to the recipient from the first family. Under section 9(3A) of THOTA, such an exchange was allowed only between two pairs.Under the new guidelines, multi-pair kidney swap transplantation will be permissible, subject to eligibility conditions. Multi-pair kidney swapping works by linking three or more donor-recipient pairs into a group. Each donor who is incompatible with their own relative instead donates a kidney to another patient in the group, while their relative receives a compatible kidney from a different donor in the same group.Approval mechanism for the transplant, mandatory documentation process, ethical safeguards and others are detailed in the guidelines.Stay updated with the latest - Click here to follow us on Instagram© IE Online Media Services Pvt LtdTags:kidney donationkidney transplantAdvertisementLoading Recommendations...Live BlogUS, Israel, Iran War Live Updates: Iran calls US demands excessive, says will announce diplomatic response in due time2 minutes agoUAE Iran War News Live Updates: Debris falls in Abu Dhabi’s Musaffah area, injures one2 minutes agoArvind Kejriwal News Live Updates: Kejriwal says will argue plea for recusal of judge, SG Mehta says people making allegations against institution8 minutes agoKarnataka 2nd PUC Results 2026 Live Updates: How to download marks memo likely at kseab.karnataka.gov.in?9 minutes agoAssembly Elections 2026 Live Updates: Modi bats for UCC, ‘One Nation, One Election’ as next agenda; says talks ‘positive’13 minutes ago