The three patients who received kidney transplants simultaneously two weeks ago as part of Semmelweis University’s living-donor kidney-exchange programme are recovering well. The remarkable medical achievement involved the coordinated efforts of around 30 healthcare professionals over six hours.
Hungary’s first three-way living-donor kidney exchange was made possible by matching three donor–recipient pairs. By exchanging donated kidneys between the pairs, the medical team overcame blood-group or immunological incompatibilities that had prevented the original donors from donating directly to their intended recipients. Following the successful procedures, all three donors were able to leave the hospital earlier, while two of the three recipients are now recovering at home. The third is expected to be discharged soon.
Following the European model, kidney exchange, also known as cross-donation, has been possible in Hungary since 2024. Under the system, if someone has a willing donor, such as a family member, but the two are immunologically incompatible, another donor–recipient pair in a similar situation can be identified. Each donor then gives a kidney to the other pair’s recipient, explains Dr Attila Szijártó, Director of the Department of Surgery, Transplantation and Gastroenterology (STéG) at Semmelweis University.
“The key message is that patients with kidney failure may be able to receive a transplant sooner if several relatives or close friends are willing to donate a kidney,” he says.
Until the summer of 2025, kidney exchange was possible only between two donor–recipient pairs. The first such procedure was performed at the Clinical Centre in Pécs earlier this year. However, following a legislative amendment last summer, several pairs can now participate in the otherwise anonymous exchange programme. This significantly increases the likelihood of finding suitable matches and, in turn, the chances of successful transplantation, Dr Szijártó adds.
He emphasises:
“Given the limited supply of organs from deceased donors, living donation is becoming increasingly important. It could help reduce the current average waiting time of three and a half years.”
Dr János Balázs Kovács, an assistant professor at STéG and head of the kidney transplantation programme, said the unprecedented operation required the coordinated efforts of almost 30 healthcare professionals, including doctors, surgical assistants, nurses and transplant coordinators, as well as around six hours of intensive work in the operating theatres.
“The procedure was carried out simultaneously in three neighbouring operating theatres. In the morning, the donors were anaesthetised and their kidneys removed, one of the procedures using robotic assistance. The kidneys were then transplanted into the recipients in the afternoon, with only a short interval between the operations,” he explains.
Speaking about the patients involved in the exchange, Dr Kovács said that one had already undergone a third kidney transplant. For the other two, immunological incompatibility had previously been an insurmountable barrier to transplantation. The three-way exchange successfully overcame that obstacle.
“Cross-donation gave us an extraordinary opportunity to improve the lives of my wife and another person without delay,” said one of the donors, Sándor Bóta, whose wife was among the recipients.
Both are now recovering at home. Mr Bóta added that, knowing what he knows now, he would make the same decision again. He also encouraged others to put their trust in the expertise of Hungary’s transplant teams.
As part of the living-donor kidney-exchange programme at Semmelweis University, two women and one man received new kidneys, offering them the prospect of a better quality of life.
