The first 4-way liver paired exchange from an interdisciplinary collaboration between health care professionals and design economists

• Published in: American journal of transplantation Vol. 23; no. 10; pp. 1612 - 1621
• Main Authors: Yilmaz, Sezai, Sönmez, Tayfun, Ünver, M. Utku, Ince, Volkan, Akbulut, Sami, Isik, Burak, Emre, Sukru
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2023
• Subjects: 4-way liver exchange; economic design; Health Personnel; Humans; Kidney Transplantation - methods; Liver; liver paired donation; liver paired exchange; liver transplantation; Liver Transplantation - methods; living donor liver transplantation; Living Donors; LL; LPE; KPE; liver paired exchange; ABOi; HRS; PELD; economic design; ABOc; living donors; PBC; ABOid; HBV; 4-way liver exchange; LDLT; GRWR; HCC; NASH; MELD; SEG 2-3; liver paired donation; HCV; RL; liver transplantation; living donor liver transplantation
• ISSN: 1600-6135; 1600-6143; 1600-6143
• DOI: 10.1016/j.ajt.2023.06.016

We report initial results of a liver paired exchange (LPE) program established at the Liver Transplant Institute at Inonu University through collaboration with design economists. Since June 2022, the program has been using a matching procedure that maximizes the number of living donor liver transplants (LDLTs) to the patients in the pool subject to the ethical framework and the logistical constraints of the program. In 1 4-way and 4 2-way exchanges, 12 LDLTs have been performed via LPE in 2022. The 4-way exchange, generated in the same match run with a 2-way exchange, is a first worldwide. This match run generated LDLTs for 6 patients, revealing the value of the capacity to carry out larger than 2-way exchanges. With only 2-way exchanges, only 4 of these patients would receive a LDLT. The number of LDLTs from LPE can be increased by developing the capacity to perform larger than 2-way exchanges in either high-volume centers or multicenter programs.