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    The first 4-way liver paired exchange from an interdisciplinary collaboration between health care professionals and design economists
    (Elsevier Science Inc, 2023) Yilmaz, Sezai; Sonmez, Tayfun; Unver, M. Utku; Ince, Volkan; Akbulut, Sami; Isik, Burak; Emre, Sukru
    We report initial results of a liver paired exchange (LPE) program established at the Liver Transplant Institute at Inonu University through collaboration with design economists. Since June 2022, the program has been using a matching procedure that maximizes the number of living donor liver transplants (LDLTs) to the patients in the pool subject to the ethical framework and the logistical constraints of the program. In 1 4-way and 4 2-way exchanges, 12 LDLTs have been performed via LPE in 2022. The 4-way exchange, generated in the same match run with a 2-way exchange, is a first worldwide. This match run generated LDLTs for 6 patients, revealing the value of the capacity to carry out larger than 2-way exchanges. With only 2-way exchanges, only 4 of these patients would receive a LDLT. The number of LDLTs from LPE can be increased by developing the capacity to perform larger than 2-way exchanges in either high-volume centers or multicenter programs.
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    Multiple Swaps Tested: Rehearsal for Triple and Five Liver Paired Exchanges
    (Elsevier Science Inc, 2024) Yilmaz, Sezai; Kizilay, Ahmet; Bayramov, Nuru; Tekin, Ahmet; Emre, Sukru
    Despite several advances in living donor liver transplant (LDLT), many potential living liver donors cannot donate their organs to their relatives because of blood group incompatibility and unsuitable anatomy. Liver paired exchange (LPE) can be used to overcome incompatibilities between living donor-recipient pairs. In this study, we report the early and late results of three and fi ve LDLTs performed simultaneously to initiate the more complex LPE program. By demonstrating that our center is capable of performing up to fi ve LDLTs, we have taken an essential step for establishing a complex LPE program.