IDEAS home Printed from
MyIDEAS: Login to save this article or follow this journal

Free riding and participation in large scale, multi-hospital kidney exchange

  • Roth, Alvin E.


    (Department of Economics, Stanford University)

  • Ashlagi, Itai


    (Sloan School of Management, MIT)

As multi-hospital kidney exchange has grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals can choose to enroll only their hard-to-match patient-donor pairs, while conducting easily-arranged exchanges internally. This behavior has already been observed. We show that as the population of hospitals and patients grows the cost of making it individually rational for hospitals to participate fully becomes low in almost every large exchange pool (although the worst-case cost is very high), while the cost of failing to guarantee individual rationality is high, in lost transplants. We identify a mechanism that gives hospitals incentives to reveal all patient-donor pairs. We observe that if such a mechanism were to be implemented and hospitals enrolled all their pairs, the resulting patient pools would allow efficient matchings that could be implemented with two and three way exchanges.

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

Article provided by Econometric Society in its journal Theoretical Economics.

Volume (Year): 9 (2014)
Issue (Month): 3 (September)

in new window

Handle: RePEc:the:publsh:1357
Contact details of provider: Web page:

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Alvin E. Roth, 2009. "What Have We Learned from Market Design?," NBER Chapters, in: Innovation Policy and the Economy, Volume 9, pages 79-112 National Bureau of Economic Research, Inc.
  2. Muriel Niederle & Alvin E. Roth, 2003. "Unraveling Reduces Mobility in a Labor Market: Gastroenterology with and without a Centralized Match," Journal of Political Economy, University of Chicago Press, vol. 111(6), pages 1342-1352, December.
  3. Roth, Alvin & Ünver, M. Utku & Sönmez, Tayfun, 2005. "A Kidney Exchange Clearinghouse in New England," Scholarly Articles 2562810, Harvard University Department of Economics.
  4. Roth, Alvin E., 1982. "Incentive compatibility in a market with indivisible goods," Economics Letters, Elsevier, vol. 9(2), pages 127-132.
  5. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2004. "Kidney Exchange," The Quarterly Journal of Economics, MIT Press, vol. 119(2), pages 457-488, May.
  6. Sönmez, Tayfun & Ünver, M. Utku, 2014. "Altruistically unbalanced kidney exchange," Journal of Economic Theory, Elsevier, vol. 152(C), pages 105-129.
  7. Parag A. Pathak & Alvin E. Roth, 2013. "Matching with Couples: Stability and Incentives in Large Markets," The Quarterly Journal of Economics, Oxford University Press, vol. 128(4), pages 1585-1632.
  8. M. Utku �nver, 2010. "Dynamic Kidney Exchange," Review of Economic Studies, Oxford University Press, vol. 77(1), pages 372-414.
  9. Saidman, Susan L. & Roth, Alvin E. & Sonmez, Tayfun & Unver, M. Utku & Delmonico, Francis L., 2014. "Increasing the Opportunity of Live Kidney Donation by Matching for Two and Three Way Exchanges," MPRA Paper 58247, University Library of Munich, Germany.
  10. Alvin E. Roth, 2007. "Repugnance as a Constraint on Markets," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 37-58, Summer.
  11. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
  12. McKinney, C. Nicholas & Niederle, Muriel & Roth, Alvin, 2005. "The collapse of a medical labor clearinghouse (and why such failures are rare)," Scholarly Articles 2570404, Harvard University Department of Economics.
  13. Tayfun Sönmez & M. Utku Ünver, 2009. "Matching, Allocation, and Exchange of Discrete Resources," Boston College Working Papers in Economics 717, Boston College Department of Economics.
  14. Guillaume R. Fréchette & Alvin E. Roth & M. Utku Ünver, 2007. "Unraveling yields inefficient matchings: evidence from post-season college football bowls," RAND Journal of Economics, RAND Corporation, vol. 38(4), pages 967-982, December.
  15. Roth, Alvin E. & Leider, Stephen, 2010. "Kidneys For Sale: Who Disapproves, and Why?," Scholarly Articles 5128483, Harvard University Department of Economics.
  16. Fuhito Kojima & Parag A. Pathak, 2009. "Incentives and Stability in Large Two-Sided Matching Markets," American Economic Review, American Economic Association, vol. 99(3), pages 608-27, June.
  17. Roth, Alvin E. & Postlewaite, Andrew, 1977. "Weak versus strong domination in a market with indivisible goods," Journal of Mathematical Economics, Elsevier, vol. 4(2), pages 131-137, August.
  18. Roth, Alvin E & Xing, Xiaolin, 1994. "Jumping the Gun: Imperfections and Institutions Related to the Timing of Market Transactions," American Economic Review, American Economic Association, vol. 84(4), pages 992-1044, September.
  19. Shapley, Lloyd & Scarf, Herbert, 1974. "On cores and indivisibility," Journal of Mathematical Economics, Elsevier, vol. 1(1), pages 23-37, March.
  20. Roth, Alvin & Niederle, Muriel, 2003. "Unraveling Reduces the Scope of an Entry Level Labor Market: Gastroenterology with and without a Centralized Match," Scholarly Articles 2623686, Harvard University Department of Economics.
  21. Ünver, M. Utku & Sönmez, Tayfun & Roth, Alvin, 2007. "Efficient Kidney Exchange: Coincidence of Wants in a Markets with Compatibility-Based Preferences," Scholarly Articles 2562809, Harvard University Department of Economics.
Full references (including those not matched with items on IDEAS)

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

When requesting a correction, please mention this item's handle: RePEc:the:publsh:1357. 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: (Martin J. Osborne)

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.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.