There is a shortage of transplantable organs almost everywhere in the world. In the US, about 6000 transplant candidates die waiting each year.1 In Pakistan, 30% to 50% of patients who needed a liver transplant are unable to secure a compatible donor, and about 10 000 people die each year waiting for a liver.2 Kidney paired donations, supported by Nobel Prize–winning kidney exchange (KE) algorithms,3 have enabled living donor kidneys to become an important source of kidneys. Exchanges supported by algorithms that systematically identify the optimal set of paired donations has yet to take hold for liver transplant.
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Corresponding Author: Saad Salman, MD, MPH, Harvard School of Public Health, Harvard University, 665 Huntington Ave, Boston, MA 02115 (firstname.lastname@example.org).
Published Online: December 7, 2022. doi:10.1001/jamasurg.2022.5440
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patients for granting permission to publish this information. We thank Alex Chan, MPH (Stanford University, Palo Alto, California), whose initiative and expertise in economics were the key driving forces for launching liver exchange. We thank Ihsan Ul Haq, MBBS, Sohail Rashid, MBBS, M. Yasir Khan, MBBS, and Siraj Haider, MBBS (Pakistan Kidney and Liver Institute, Lahore, Pakistan), who led the procedures as part of the 3-way liver paired donations reported here. Contributors were compensated for their work.
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