Background
Kidney paired donation has been at first performed at our institution in 2003. Until 2011 only four 2-way exchanges were performed. Since 2011 the kidney exchange started at our institution as coordinated program. All the incompatible pairs are collected prospectively in the database. The matching run is performed every three monts with on average 20 pairs included for matching.

Material and Methods
There were in total 34 paired live kidney transplants (KTx) performed in Czech since 2003, of those 26 since 2011, those we assessed. There were eight 2-way, one 4-way, two 5-way and one 6- way domino kidney paired exchanges performed, two altruistic samaritan donors entered the scheme. There were 5 cases of re-transplant, of those four second and one third KTx, some 15% paired KTx. Two surgeons perfomed all the transplants, one did all the mininvasive nephrectomies using Hand Assisted Retroperitoneoscopic (HARS) live donor nephrectomy technique.

Results
Mean recipient age was 45.7 years (SD 11.9), four patients had their second and one third transplant done, mean SCr on discharge was 126 umol/l (SD 48.5), equivalent of 1.43 mg/dl (SD 0.55). There was one case of delayed graft function due to early rejection observed. The program did help some 26 patients so far, the database includes around 40 pairs to the date.

Conclusion
Kidney paired donation program can be run with success even at single institution, this limits some of the highly sensitised patients as well as blood group 0 recipients. Also, the bigger is the group for matching, the higher might bet the number of transplants. Possible cooperation within European centres would help to treat more patients with the best threatment modality – live donor kidney transplantion.