Although some patients find donors for themselves, the transplant may not be performed due to blood and tissue incompatibility of the donor and the recipient. Kidney transplant can be performed for two pairs in the same condition by crossing over the donors. This method is called cross-over transplantation.

The patients who have a living donor with blood type incompatibility should present to transplant centers to popularize this technique. The higher the number of patients in this condition, the larger the pool of donors and recipients becomes; thus, the chance of cross-over transplantation increases. Donor surgeries are started simultaneously and the kidneys are removed for transplantation at the same time in cross-over transplantation.