Sequential Kidney Exchange

The traditional literature on kidney exchange assumes that all components of the exchange must occur simultaneously. Unfortunately, the number of operating rooms required for concurrent surgeries poses a significant constraint on the beneficial exchanges that may be attained. The basic insight of this paper is that incentive compatibility does not require simultaneous exchange; rather, it requires that organ donation occurs no later than the associated organ receipt. Using sequential exchanges may relax the operating-room constraint and thereby increase the number of beneficial exchanges. We show that most benefits of sequential exchange can be accomplished with only two concurrent operating rooms.