Kidney exchange

Abstract

This work proposes kidney exchange programs to increase the number of transplants and match quality of transplanted kidneys. The approach extends the top trading cycles mechanism for house allocation to pair donor-recipient couples who cannot exchange organs. Kidneys from incompatible living donors can be used through an exchange arrangement between two pairs, improving the welfare of both patients. The indirect exchange program upgrades patients in the cadaver queue in return for their incompatible donors donating their kidneys to someone on the queue. This negatively impacts type O patients who have no living donors. Patient and donor characteristics are used for simulations in which rational and cautious preference constructions and different population sizes are considered. Results suggest the TTCC mechanism increases the proportion of total transplants from live kidney donors, especially for larger populations, and reduces patient waiting time. The mechanism is also more efficient and usually gives better match quality than competing mechanisms. The authors conclude these programs offer benefits to patients with and without live donors and provide practical, implementable steps for implementation. – AI-generated abstract.