Editing Organ transplantation (section)

==== Paired exchange ====
[[File:Pairwise exchange.svg|thumb|right|250px|Diagram of an exchange between otherwise incompatible pairs]]
A "paired-exchange" is a technique of matching willing living donors to compatible recipients using [[serotype|serotyping]]. For example, a spouse may be willing to donate a kidney to their partner but cannot since there is not a biological match. The willing spouse's kidney is donated to a matching recipient who also has an incompatible but willing spouse. The second donor must match the first recipient to complete the pair exchange. Typically the surgeries are scheduled simultaneously in case one of the donors decides to back out and the couples are kept anonymous from each other until after the transplant. Paired-donor exchange, led by work in the [https://web.archive.org/web/20060425142144/http://www.nepke.org/ New England Program for Kidney Exchange] as well as at Johns Hopkins University and the Ohio organ procurement organizations, may more efficiently allocate organs and lead to more transplants.

Paired exchange programs were popularized in the ''[[New England Journal of Medicine]]'' article "Ethics of a paired-kidney-exchange program" in 1997 by L.F. Ross.<ref>{{cite journal |doi=10.1056/NEJM199706123362412 |vauthors=Ross LF, Rubin DT, Siegler M, Josephson MA, Thistlethwaite JR, Woodle ES |title=Ethics of a paired-kidney-exchange program |journal=New England Journal of Medicine |volume=336 |issue=24 |pages=1752–55 |date=June 1997 |pmid=9180096 }}</ref> It was also proposed by Felix T. Rapport<ref>{{cite book |title=Legal and Ethical Aspects of Organ Transplantation |via=Google Books |publisher=Cambridge University Press |author=David Price |year=2000 |isbn=978-0-521-65164-6 |page=[https://archive.org/details/legalethicalaspe0000pric/page/316 316] |url=https://archive.org/details/legalethicalaspe0000pric/page/316 }}</ref> in 1986 as part of his initial proposals for live-donor transplants "The case for a living emotionally related international kidney donor exchange registry" in ''Transplant Proceedings''.<ref>{{cite journal |author=Rapaport FT |title=The case for a living emotionally related international kidney donor exchange registry |journal=Transplant. Proc. |volume=18 |issue=3 Suppl 2 |pages=5–9 |date=June 1986 |pmid=3521001}}</ref> A paired exchange is the simplest case of a much larger exchange registry program where willing donors are matched with any number of compatible recipients.<ref>{{cite web |url=http://www.nepke.org/math.htm |archive-url=https://web.archive.org/web/20060614163646/http://www.nepke.org/math.htm |archive-date=14 June 2006 |title=New England Program for Kidney Exchange}}</ref> Transplant exchange programs have been suggested as early as 1970: "A cooperative kidney typing and exchange program."<ref>{{cite journal |vauthors=Horisberger B, Jeannet M, De Weck A, Frei PC, Grob P, Thiel G |title=A cooperative kidney typing and exchange program |journal=Helvetica Medica Acta |volume=35 |issue=4 |pages=239–47 |date=October 1970 |pmid=4918735}}</ref>

The first pair exchange transplant in the US was in 2001 at [[Johns Hopkins Hospital]].<ref>{{cite web |url=http://www.hopkinshospital.org/health_info/Bladder/Reading/triple_transplant.html |title=The Johns Hopkins Hospital &#124; Johns Hopkins Medicine in Baltimore, MD |publisher=Johns Hopkins Medicine |work=Hopkinshospital.org |date=24 June 2011 |access-date=17 April 2013}}</ref> The first complex multihospital kidney exchange involving 12 people was performed in February 2009 by The Johns Hopkins Hospital, [[Barnes-Jewish Hospital]] in [[St. Louis]] and Integris Baptist Medical Center in [[Oklahoma City]].<ref>{{cite news |title=Johns Hopkins Leads First 12-Patient, Multicenter "Domino Donor" Kidney Transplant |url=http://www.hopkinsmedicine.org/news/media/releases/johns_hopkins_leads_first_12_patient_multicenter_domino_donor_kidney_transplant |access-date=25 December 2013 |newspaper=Johns Hopkins Medicine |date=16 February 2009 |author=Eric Vohr |location=Baltimore, Maryland}}</ref> Another 12-person multihospital kidney exchange was performed four weeks later by [[Saint Barnabas Medical Center]] in [[Livingston, New Jersey]], [[Newark, New Jersey|Newark Beth Israel Medical Center]] and [[New York-Presbyterian Hospital]].<ref>{{cite news |url=http://www.nj.com/news/index.ssf/2009/06/kidney_donations_connect_stran.html |title=Kidney donations connect strangers in "Chain of Life" forged by transplants |newspaper=The Star-Ledger |date=5 June 2009 |access-date=11 July 2009 |author=Amy Ellis Nutt/The Star-Ledger}}</ref> Surgical teams led by Johns Hopkins continue to pioneer this field with more complex chains of exchange, such as an eight-way multihospital kidney exchange.<ref>{{cite web |url=https://www.sciencedaily.com/releases/2009/07/090707183138.htm |title=First 16-patient, Multicenter 'Domino Donor' Kidney Transplant |website=Science Daily |date=11 July 2009 |access-date=14 July 2009}}</ref> In December 2009, a 13 organ 13 recipient matched kidney exchange took place, coordinated through Georgetown University Hospital and Washington Hospital Center, Washington, DC.<ref>{{cite news |url=http://www.cnn.com/2009/HEALTH/12/14/kidney.transplant/index.html |title=Massive transplant effort pairs 13 kidneys to 13 patients |publisher=CNN |date=14 December 2009 |access-date=24 December 2013 |author=Val Willingham}}</ref>