0 551 847 5181
caprazkaracigernakli@inonu.edu.tr
Bulgurlu, 44000 Battalgazi/Malatya
Reinventing Liver Paired Exchange
0 551 847 5181
caprazkaracigernakli@inonu.edu.tr
Bulgurlu, 44000 Battalgazi/Malatya
Living donor liver transplants constitute more than 80% of liver transplants in Turkey. These procedures involve transplanting a portion of the voluntary donor's liver to the recipient. However, in many cases, medical tests reveal incompatibility between the patient and the donor.
Medical incompatibilities between patients and their willing donors may arise from factors such as blood type incompatibility, the donated liver part—typically the right or left lobe—being insufficient in size for the patient's requirements, the donor's remaining liver being too small for their vital needs, and anatomical variations of the hepatic artery.
A donor who is medically incompatible with their intended recipient may still be compatible with another patient. Likewise, a patient who is incompatible with their donor may be compatible with another patient's donor. In such situations, patients can acquire a medically compatible donor through a donor exchange. This process, where two or more patients exchange their donors to ensure medically compatible transplants for each recipient, is known as liver paired exchange.
Our institute is equipped to perform up to seven simultaneous liver transplants, thanks to our skilled medical personnel and advanced operating rooms. Practically, this means that our institute can (and does) execute liver paired exchanges as large as 7-way. In simultaneous transplants, donor and patient matches are determined through the "Banu Bedestenci Sönmez Liver Paired Exchange System," launched in June 2022. This system operates on the fundamental principle of delivering the most suitable transplants to the maximum number of patients by utilizing the smallest possible liver exchanges. Consequently, larger exchanges are only pursued when a distinct advantage is evident. Following this guiding principle, our institute has achieved a sequence of groundbreaking milestones: the world's first 4-way liver paired exchange on July 7, 2022, the world's first 5-way liver paired exchange on October 4, 2023, the world's first 6-way liver paired exchange on January 23, 2024, and most recently, the world's first 7-way liver paired exchange on July 2, 2024.
While patients may be medically compatible with their own donors, it is also possible for them to receive a transplant from more suitable donors through liver paired exchange. Therefore, at our Institute, patients and their donors can participate in liver paired exchange, even if they are medically compatible with each other.
The fundamental principle of the Banu Bedestenci Sönmez Liver Paired Exchange System is to provide a compatible transplant to as many patients as possible, while ensuring that each patient receives a transplant that is at least as suitable for them as their own donor's.
“55-year-old Kenan Atılgan, who feels extremely healthy and underwent a liver transplant surgery three months ago, says: "I had a 3-way liver transplant surgery on April 25, 2023. Three months have passed, and I feel extremely healthy. We have had trust in Malatya from the beginning. I am so glad I came here. We are fortunate to have met Sezai hodja. Besides being an excellent surgeon, the best part about our doctor is his compassion. Sometimes, I think he never sleeps because whenever we call at night, he responds immediately.”
“I am 28 years old, and I donated to Ali Güner. The process started like this: My father needed a liver transplant. Since my liver volume was smaller than my father's, the transplant didn't take place. When our doctor suggested putting me on the paired liver exchange pool, I agreed, but I wasn't very hopeful. Our blood type is 0+, which means we can donate to anyone but can only receive from our own blood group, so I didn't have high hopes. I also didn't know that there were 3-way and 4-way liver paired exchanges. They called us during the Ramadan holiday and told us that such a transplant was going to happen. They asked if I was determined. I was determined, and I came here and met Ali. We became like family friends. I donated an organ to Ali, Ali's sibling donated to someone else, and that person's niece donated an organ to my father. We are all doing very well now. I am experiencing the happiness of saving two lives. When I compare my condition before the surgery to how I am now, there is no difference; I am perfectly healthy.”
“I am 32 years old, and I am a native of Mersin. I have been battling this disease for 30 years. Malatya was recommended to us, and we came and met Sezai hodja. We were put on the cadaver list. However, no cadaver became available for us for 5-6 years. Later, they suggested a liver paired exchange surgery. We agreed to it. I brought my sibling, but my sibling's donation wasn't a match for me, so my sibling became a donor to another patient, and I received Esra's donor. I am very thankful to Esra. If it weren't for her, maybe this paired liver exchange wouldn't have happened. Right now, my health is very good. In the past, I couldn't even walk.”
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