How a centre joins the registry, what data is mandatory, and the workup a donor needs before a pair can be matched.
Two categories of centre, two organ domains, one national pool.
Both participate on the same terms and search the same pool. The category is recorded on the centre, not used to segregate matching.
A centre may be licensed for one or both. Both pairs in an exchange must be registered for the same organ — the registry will not propose a cross-organ swap.
The centre submits its transplant licence — kidney, liver, or both — through the registration form.
The platform's site administrator checks it. If it is valid and has not expired, the hospital registration is approved.
Once registration is complete the centre is given an administrator, who manages everyone else who joins under it.
Nephrologists, liver surgeons and transplant coordinators register by selecting their hospital from the list of approved centres. The Hospital Admin reviews each registration and activates it.
A consultant may grant a transplant coordinator the right to manage their patients — and, where there is more than one coordinator, choose which of them handles which patient.
Patients and donors do not register themselves. A pair reaches the registry through the consultant looking after them. Register as a consultant →
The kidney swap engine is a multi-criteria decision model, built from two classical methods. They are not interchangeable, and each does a different job:
Hard gates, applied one at a time, each of which removes candidates outright: blood group compatibility, donor-specific antibody above the threshold, and any antigen the consultant has listed as unacceptable. A candidate eliminated here is not scored — no combination of good numbers elsewhere brings it back.
What survives is scored rather than filtered. HLA matches earn points weighted by locus — DRB1 counts for 15, DQB1 for 7.5, A and B for 4, C and DPB1 for 2 — and the total is then reduced by the worst donor-specific antibody and by the eplet load, so a clean crossmatch outranks a marginally better tissue match with antibody against it.
Both steps run separately in each direction. A pairing can pass every gate one way and fail on the first gate the other way, which is the reason chains exist. The FAQ works through an example.
A pair is registered as soon as these are recorded, and enters the matching pool only once all of them are present. Until then it is listed under Awaiting data and skipped by every search.
| Requirement | Detail |
|---|---|
| Aadhaar-based registration | For both donor and recipient. The twelve digits are keyed from the card, but only the last four are stored — enough to confirm identity against the document, without the registry holding the number. |
| Donor workup | Complete reports, with medical and surgical fitness established. |
| HLA typing — both sides | Minimum A, B, DR and DQ. C and DP are optional and improve the score when present; the registry accepts eleven loci in all. |
| Recipient SAB | Single antigen bead results, imported as CSV. Templates are provided — a generic layout plus the One Lambda LABScreen and HLA Fusion exports, read exactly as the instrument produces them. |
Five groups of data, plus two sets of donor criteria.
Name, date of birth, gender, contact, address, blood group, weight and height with calculated BMI.
Profession, and the background relevant to candidacy.
Cause of CKD or CLD, previous failed transplant, previous positive crossmatch, dialysis start, failed access, comorbidities.
Clinical findings recorded at assessment.
Serology — CMV IgG, EBV IgG, HIV, IgM and IgG anti-HBc, HBsAg, HCV — each as positive, negative or unknown, plus PRA % and imaging.
Eleven loci, two alleles each. A, B, DRB1 and DQB1 mandatory.
Will this recipient accept an EBV IgG positive donor? A CMV IgG positive donor? An HBsAg positive donor, an HCV positive donor, a diabetic donor, a donor with hypertension? Each answer narrows who they will be offered.
Acceptable maximum donor age, maximum donor BMI, minimum donor GFR, maximum number of arteries, maximum number of veins.
Everything the recipient form collects, plus the surgical assessment — because the donor is also an operative candidate.
Recorded for the artery, the vein and the ureter:
The form also records general condition and cardiac assessment — blood pressure and pulse, diabetes and HbA1c, hypertension, CVS, RS, PA and CNS examination, ejection fraction, LVH, RWMA, pulmonary hypertension, diastolic dysfunction and pericardial effusion — together with previous transfusions, surgeries and current medications.
Uploaded as name-masked PDFs. Masking matters: these documents become visible to the counterpart centre once a swap request is accepted, and the registry protects identity until then — a name printed inside a scan would defeat that.
The registration pathway, the antibody gates and the HLA scoring are the same. What differs is that a liver graft has to fit — so two further gates apply, and neither is a preference a consultant can waive:
| Measure | What it means |
|---|---|
| GRWR graft-to-recipient weight ratio |
Computed for both lobes from the donor's measured lobe weights and the recipient's weight. At least one lobe must meet the GRWR that recipient requires. |
| FLR future liver remnant |
What is left in the donor after the graft is taken, as a percentage. The registry's configured floor is 30%. A pairing that satisfies GRWR but leaves the donor below it does not pass. |
Liver registration additionally records the aetiology of chronic liver disease, portal vein thrombosis with grade and extent, TIPS, previous HPB surgery and HCC status on the recipient side; and on the donor side lobe weights, liver attenuation index, MR fat fraction, fibrosis, steatosis and inflammation, hepatic and portal venous anatomy, and the autoantibody panel — ANA, ASMA, AMA, LKM, SLA, ANCA and AAA, with titres.
On a kidney pair the graft-size section reports itself as not applicable rather than printing empty rows, and vice versa. The report shows the gates that apply to the organ in front of you.
Blank CSV templates for recipient HLA typing, donor HLA typing and SAB results — each with a worked example row — are on the Downloads screen inside the portal, along with exports of the registry's own data as CSV, Excel or PDF. The header row is what the importer matches on, so it should not be renamed.