For the first time in the history of Pakistan, ‘three-in-one’ swap liver transplants were simultaneously performed at the Pakistan Kidney and Liver Institute and Research Center (PKLI&RC) in March, where three people donated parts of their livers to unrelated recipients in exchange for liver donations to save lives of their blood relatives.

Liver Paired Donation or swap transplant is a new concept in Pakistan, where a person donates an organ or part of their liver to an unrelated person in exchange for organ donation for their blood relatives due to blood group incompatibility or technical reasons.
Prof. Faisal Saud Dar, Dean PKLI&RC, mentioned a transplant is often the only definitive treatment option for people suffering from liver cancer or cirrhosis but unfortunately, around 30-50% of these patients are unable to find a donor, and in Pakistan, nearly 10,000 people die annually waiting for a liver.

At PKLI, the three teams comprising five transplant surgeons and other support staff performed the 7-8 hours long procedures simultaneously at six operation theatres at the health facility, during which they removed portions of livers from three donors and then transplanted them to the unrelated recipients at the same time.

Prof. Faisal Saud Dar expressed gratitude to the team and told that his team had performed one of the most unique Swap liver transplant procedures in the history of Pakistan, where three persons, two sons and a daughter, donated parts of livers to unrelated recipients in exchange for liver donations for their fathers. All these surgeries went smoothly ‘Alhamdulillah’ and all the transplant recipients and donors have been discharged and are in good health.

It is pertinent to mention that these three male recipient patients had their blood relatives as donors but due to a mismatch of blood groups and some other technical issues they could not receive the liver donations from their blood relatives. Considering it a case of Liver Paired Donation, PKLI’s consultants prepared a case of a three-in-one swap liver transplant and forwarded it to Punjab Human Organ Transplantation Authority (PHOTA) for approval, which allowed the procedure as per their approved swap transplant policy.

Explaining the ‘unrelated swap transplants’ Prof. Dar said to receive an organ from an unrelated person, the recipient must have a blood relative as the donor, whose organ could be transplanted to another person in exchange for a donation from that person’s blood relative for him. He further mentioned that due to the blood group incompatibility, technical reasons and issues of tissue matching, liver transplants were not possible within blood relatives, so we successfully performed the swap transplants that saved the lives of three people.

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