Reinventing Liver Paired Exchange



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Three-way Exchange

Cüneyt is a liver patient with blood type O. Alp is willing to donate a liver lobe to his brother Cüneyt, but due to blood type incompatibility (his blood type is A), he cannot proceed with the donation. Similarly, liver patient Ayşe and her niece Banu encounter a similar issue because Ayşe has blood type A, making her blood type incompatible with Banu, who has blood type B. Consequently, Banu cannot be a donor for her aunt Ayşe.


While Canan is a willing donor with blood type compatibility for her liver patient husband Barış, they face a different challenge. Barış has blood type B, whereas Canan has blood type O. However, Canan's weight is 50 kg, and even her larger right liver lobe is not sufficiently large for her 80 kg husband. As a result, Canan cannot donate a liver lobe to Barış due to size incompatibility.


In summary, two patients face blood type incompatibility, and one patient encounters size incompatibility with their co-registered willing donors. Fortunately, the liver paired exchange system comes to the rescue of these three patients. Alp donates a liver lobe to Ayşe instead of Cüneyt, Banu donates a liver lobe to Barış instead of Ayşe, and Canan donates a liver lobe to Cüneyt instead of Barış. Thanks to this donor exchange, all three patients receive compatible liver transplants.

Three-way Exchange