Advanced Search
MyIDEAS: Login to save this article or follow this journal

Recipient Choice Can Address the Efficiency-Equity Trade-off in Kidney Transplantation: A Mechanism Design Model


Author Info

  • Xuanming Su

    (Haas School of Business, University of California, Berkeley, California 94720)

  • Stefanos A. Zenios

    (Graduate School of Business, Stanford University, Stanford, California 94305)

Registered author(s):


    In kidney allocation, transplant candidates may have private information about their propensity to enjoy good outcomes after transplantation or about their relative expected improvement in quality of life after transplantation. This paper develops a mechanism design model to investigate the effect of such information asymmetry on the kidney allocation system. In this model, there are n transplant queues corresponding to n candidate types. Candidate types are only observed by the candidates, and each candidate chooses the queue to join by reporting a type. Kidneys have heterogeneous types, and each kidney will be assigned to one of the queues depending on its type. Candidates report their type strategically to join the queue that maximizes their utility. Candidate utility depends on the type of kidney received and the expected waiting time, which is calculated using fluid approximations. We consider two alternative social welfare functions: aggregate utility (emphasizing efficiency) and minimum utility across all candidates (emphasizing equity). The kidney allocation problem is to divide the organ supply among the different queues so that social welfare is maximized, and this problem is solved explicitly under both objective functions. There are three findings: (1) The allocation mechanism induces truth telling by ensuring that candidates who wait longer receive better kidneys; (2) Information rents are earned by high-risk candidates under the efficiency objective and by low-risk candidates under the equity objective; (3) a choice-based kidney allocation system in which candidates choose the type of queue to join leads to outcomes in the middle of the efficiency-equity spectrum.

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL:
    Download Restriction: no

    Bibliographic Info

    Article provided by INFORMS in its journal Management Science.

    Volume (Year): 52 (2006)
    Issue (Month): 11 (November)
    Pages: 1647-1660

    as in new window
    Handle: RePEc:inm:ormnsc:v:52:y:2006:i:11:p:1647-1660

    Contact details of provider:
    Postal: 7240 Parkway Drive, Suite 300, Hanover, MD 21076 USA
    Phone: +1-443-757-3500
    Fax: 443-757-3515
    Web page:
    More information through EDIRC

    Related research

    Keywords: kidney allocation; efficiency-equity trade-off; mechanism design; hidden information; achievable regions; fluid queues;


    No references listed on IDEAS
    You can help add them by filling out this form.


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as in new window

    Cited by:
    1. Caulkins, Jonathan P., 2010. "Might randomization in queue discipline be useful when waiting cost is a concave function of waiting time?," Socio-Economic Planning Sciences, Elsevier, vol. 44(1), pages 19-24, March.
    2. Monali Malvankar-Mehta & Bin Xie, 2012. "Optimal incentives for allocating HIV/AIDS prevention resources among multiple populations," Health Care Management Science, Springer, vol. 15(4), pages 327-338, December.
    3. Nicoló, Antonio & Rodríguez-Álvarez, Carmelo, 2012. "Transplant quality and patientsʼ preferences in paired kidney exchange," Games and Economic Behavior, Elsevier, vol. 74(1), pages 299-310.


    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.


    Access and download statistics


    When requesting a correction, please mention this item's handle: RePEc:inm:ormnsc:v:52:y:2006:i:11:p:1647-1660. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Mirko Janc).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.