Kidney exchanges within a single transplant center

In the emerging ecology of kidney exchange in the U.S., there are more and more exchange transplants that are  "internal" exchanges among the patient-donor pairs of a single transplant center..

Here's a recent news story that's indicative of that:
The first internal paired kidney exchange completed at LLUMC, chain started by altruistic donor-- Two adults now have a longer, healthier life ahead of them thanks to two complete strangers.

"The first internal paired kidney exchange was successfully completed at Loma Linda University Medical Center (LLUMC) late last month.

"The chain began with an altruistic donor from Orange County who gave a kidney to an individual from the Inland Empire. That recipient had a donor that was not a compatible match and was able to give to another individual in need of a kidney. The four surgeries took place Monday, Nov. 28.

...

"Living-donor chains have the potential to dramatically reduce transplant waiting times for thousands of patients,” said Rafael Villicana, MD, a transplant nephrologist and the medical director of the kidney transplant program at Loma Linda University (LLU) Transplantation Institute. "This is the best way for patients with incompatible donors to be transplanted quickly and achieve the best results."Having a living donor can eliminate the wait. But in one-third of such cases, a transplant can't be done because the immune systems of the patient and a willing donor don't match.

"Each chain begins when an altruistic person steps forward to donate a kidney, expecting nothing in return.

"While Loma Linda has been involved in other kidney exchanges, this is the first that was all done in house.

"Approximately 130 kidney transplants are performed at LLUMC annually."