The shortage of donor organs is one of the major barriers of transplantation worldwide. After the success of the direct exchange donor (swap) program in Korea since 1991, a swap-around program has been developed. Recently, a web-based (computerized) algorithm to facilitate donor kidney exchange was devised and tested in multi-center settings. An excellent long-term outcome was achieved by using the donor exchange program as an option to reduce the donor organ shortage. Herein, we discussed on the current status of the exchange donor renal transplantation in Korea, a couple of problems we have had, and future directions we have to head and make better to improve organ donation activities.
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