TY - JOUR
T1 - Liver paired exchange
T2 - A US single-center experience—Pairs, chains, and use of compatible pairs
AU - Klair, Tarunjeet
AU - Fritze, Danielle
AU - Halff, Glenn
AU - Patnaik, Ronit
AU - Thomas, Elizabeth
AU - Abrahamian, Gregory
AU - Cullen, Jonathan
AU - Cigarroa, Francisco
N1 - Publisher Copyright:
Copyright © 2024 American Association for the Study of Liver Diseases.
PY - 2024/10/1
Y1 - 2024/10/1
N2 - In the United States, the discrepancy between organ availability and need has persisted despite changes in allocation, innovations in preservation, and policy initiatives. Living donor liver transplant remains an underutilized means of improving access to timely liver transplantation and decreasing waitlist mortality. Liver paired exchange (LPE) represents an opportunity to overcome living donor liver transplant pair incompatibility due to size, anatomy, or blood type. LPE was adopted as a strategy to augment access to liver transplantation at our institution. Specific educational materials, consent forms, and selection processes were developed to facilitate LPE. From 2019 through October 2023, our center performed 11 LPEs, resulting in 23 living donor liver transplant pairs. The series included several types of LPE: those combining complementary incompatible pairs, the inclusion of compatible pairs to overcome incompatibility, and the use of altruistic nondirected donors to initiate chains. These exchanges facilitated transplantation for 23 recipients, including 1 pediatric patient. LPE improved access to liver transplantation at our institution. The ethical application of LPE includes tailored patient education, assessment and disclosure of exchange balance, mitigation of risk, and maximization of benefit for donors and recipients.
AB - In the United States, the discrepancy between organ availability and need has persisted despite changes in allocation, innovations in preservation, and policy initiatives. Living donor liver transplant remains an underutilized means of improving access to timely liver transplantation and decreasing waitlist mortality. Liver paired exchange (LPE) represents an opportunity to overcome living donor liver transplant pair incompatibility due to size, anatomy, or blood type. LPE was adopted as a strategy to augment access to liver transplantation at our institution. Specific educational materials, consent forms, and selection processes were developed to facilitate LPE. From 2019 through October 2023, our center performed 11 LPEs, resulting in 23 living donor liver transplant pairs. The series included several types of LPE: those combining complementary incompatible pairs, the inclusion of compatible pairs to overcome incompatibility, and the use of altruistic nondirected donors to initiate chains. These exchanges facilitated transplantation for 23 recipients, including 1 pediatric patient. LPE improved access to liver transplantation at our institution. The ethical application of LPE includes tailored patient education, assessment and disclosure of exchange balance, mitigation of risk, and maximization of benefit for donors and recipients.
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U2 - 10.1097/LVT.0000000000000395
DO - 10.1097/LVT.0000000000000395
M3 - Article
C2 - 38727617
AN - SCOPUS:85204164744
SN - 1527-6465
VL - 30
SP - 1013
EP - 1025
JO - Liver Transplantation
JF - Liver Transplantation
IS - 10
ER -