Abstract: We study the pairwise organ exchange problem among groups motivated by real-world applications and consider two types of group formulations. Each group represents either a certain type of patient-donor pairs who are compatible with the same set of organs, or a set of patient-donor pairs who reside in the same region. We address a natural research question, which asks how to match a maximum number of pairwise compatible patient-donor pairs in a fair and individually rational way. We first propose a natural fairness concept that is applicable to both types of group formulations and design a polynomial-time algorithm that checks whether a matching exists that satisfies optimality, individual rationality, and fairness. We also present several running time upper bounds for computing such matchings for different graph structures.