Background: An exchange living donor program for liver transplantation, similar to the exchange living donor kidney program, was proposed to avoid ABO-incompatible adult living donor liver transplantation (LDLT). The objective of this study was to present updated changes in exchange adult LDLT program at our institution.
Methods: Between January 2003 and December 2011, approximately 2,182 adult LDLT cases were included in this study. During this period, 26 paired-exchange donor LDLT cases were performed (1.2%).
Results: Of the 26 paired-exchange donor LDLT cases, 22 pairs were matched due to ABO-incompatibility, and 4 pairs were matched because of cascade allocation of unrelated donors or relatively small graft volume to the recipients. A total of 28 living donors were included in the 26 paired-exchange donor LDLT cases because of inclusion of two dual-graft transplants. Elective surgery was performed in 22 cases, and urgent operation was performed in 4 cases. The overall 1-year and 5-year patient and graft survivals were both 96.2% and 90.1%, respectively.
Conclusions: Our experience suggests that the paired-exchange donor program for adult LDLT seems to be a feasible modality to overcome donor ABO incompatibility. Reasonably acceptable indications for donor exchange LDLT will be proposed in near future.