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Liver paired donation — LPD

Liver paired donation

Two or more living donor/candidate pairs swapping liver segments to make a compatible match

Sometimes a transplant candidate has someone who wants to donate a portion of their liver to them, but tests reveal that the liver would not be a good medical match. Liver paired donation (LPD), also called a liver swap, gives that transplant candidate another option. In LPD, living donor liver-segments are exchanged, so each donor donates and each recipient receives a compatible transplant.

What is liver paired donation and is it right for me?

Your transplant team may ask you to think about a live liver paired donation, sometimes called a liver swap. A liver swap usually happens when a donor does not match a candidate. This could be because the potential donor’s blood type is not compatible to the candidate’s blood type. It may also be that blood vessels and bile ducts of the living donor’s liver does not match the candidate. Size difference between the donor and candidate is another reason for not matching. When a donor and candidate do not match, the donor cannot donate directly to that candidate.

What is liver paired donation, or liver swap?

Liver swaps match donor and candidate pairs with other pairs within the same hospital network, region or even across the nation. Some pairs enter because they do not match each other as they had hoped. Others enter to find a better match. Pairs who do match can enter to help those who do not match receive a transplant.

Here is an example:

Amir wants to donate part of his liver to Shauna, but they do not match. Mary wants to donate to Carlos, but they do not match. Mary is a match for Shauna, and Amir matches Carlos. Swapping donors and candidates in this case allows both transplants to happen. This is liver paired donation, also called liver swap.

Diagram to illustrate how liver paired donation works: Using colors and lines to show matches work between donors and recipients. Top row: Amir (donor, is blood type B) wants to donate to Shauna (candidate, Blood type A). Because of different blood types, this isn't a match. Bottom row: Mary (donor, blood type A) wants to donate to Carlos (candidate, blood type B). Because of different blood types, this isn't a match. But, Mary is a match for Shauna; and Amir is a match for Carlos.

What are the benefits of taking part in a liver swap?

  • The transplant may last longer and the candidate may have a better chance of long-term survival
  • Candidates may not have to wait as long for a transplant, decreasing their risk of dying while awaiting transplantation
  • Candidates can have surgery while they are healthier and better able to withstand surgery
  • Donors help their loved one receive a living donor liver transplant
  • Donors and candidates can help other patients receive a transplant

For more information on a liver swap, talk to your transplant team.

Learn more


Patients, family members, and friends needing additional information about living donation and organ transplant, contact the OPTN Patient Services Line at 1-888-894-6361 or [email protected].

Meet David and Mark

Liver recipient and living donor

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