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Living Donor Exchange Poses New Option for Liver Transplantation
Programs Offer Alternative for ABO-Incompatible Transplants

Two major transplant centers in Hong Kong and South Korea released results from their paired donor exchange programs for living donor liver transplantation (LDLT).  A single paired exchange, performed by the Hong Kong team under emergency circumstances, was a success. The Korean team reported 16 donor exchanges conducted over a 6-year period were successful.

The donor exchange practice raises ethical and cultural concerns. All donors involved must understand the potential risks to their own health, as well as the possibility that while the recipient of their donated organ may survive, their own relative, for whose benefit they have entered into the exchange program, may experience an adverse outcome.

Both transplant centers achieved high success rates, with all donors and all but one recipient making complete recoveries. Both teams conclude exchange donor programs for LDLT are a viable alternative to donor ABO-incompatibility and should become accepted in countries where paired exchange programs for living-donor kidney transplantation have already been established.