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Kidney Exchange

Author

Listed:
  • Alvin E. Roth
  • Tayfun Sonmez
  • M. Utku Unver

Abstract

Most transplanted kidneys are from cadavers, but there are also substantial numbers of transplants from live donors. Recently, there have started to be kidney exchanges involving two donor-patient pairs such that each donor cannot give a kidney to the intended recipient because of immunological incompatibility, but each patient can receive a kidney from the other donor. Exchanges are also made in which a donor-patient pair makes a donation to someone on the queue for a cadaver kidney, in return for the patient in the pair receiving the highest priority for a compatible cadaver kidney when one becomes available. We explore how such exchanges can be arranged efficiently and incentive compatibly. The problem resembles some of the housing' problems studied in the mechanism design literature for indivisible goods, with the novel feature that while live donor kidneys can be assigned simultaneously, the cadaver kidneys must be transplanted immediately upon becoming available. In addition to studying the theoretical properties of the design we propose for a kidney exchange, we present simulation results suggesting that the welfare gains would be substantial, both in increased number of feasible live donation transplants, and in improved match quality of transplanted kidneys.

Suggested Citation

  • Alvin E. Roth & Tayfun Sonmez & M. Utku Unver, 2003. "Kidney Exchange," NBER Working Papers 10002, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:10002
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    References listed on IDEAS

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    1. Szilvia Papai, 2000. "Strategyproof Assignment by Hierarchical Exchange," Econometrica, Econometric Society, vol. 68(6), pages 1403-1434, November.
    2. Gary S. Becker & Julio Jorge Elías, 2007. "Introducing Incentives in the Market for Live and Cadaveric Organ Donations," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 3-24, Summer.
    3. Paul R. Milgrom, 1985. "Auction Theory," Cowles Foundation Discussion Papers 779, Cowles Foundation for Research in Economics, Yale University.
    4. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2004. "Kidney Exchange," The Quarterly Journal of Economics, Oxford University Press, vol. 119(2), pages 457-488.
    5. Jackson, Matthew O. & Palfrey, Thomas R., 2001. "Voluntary Implementation," Journal of Economic Theory, Elsevier, vol. 98(1), pages 1-25, May.
    6. Atila Abdulkadiroglu & Tayfun Sonmez, 1998. "Random Serial Dictatorship and the Core from Random Endowments in House Allocation Problems," Econometrica, Econometric Society, vol. 66(3), pages 689-702, May.
    7. Sonmez, Tayfun, 1996. "Implementation in generalized matching problems," Journal of Mathematical Economics, Elsevier, vol. 26(4), pages 429-439.
    8. Lars-Gunnar Svensson, 1999. "Strategy-proof allocation of indivisible goods," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 16(4), pages 557-567.
    9. Shapley, Lloyd & Scarf, Herbert, 1974. "On cores and indivisibility," Journal of Mathematical Economics, Elsevier, vol. 1(1), pages 23-37, March.
    10. Yan Chen & Tayfun Sönmez, 2002. "Improving Efficiency of On-Campus Housing: An Experimental Study," American Economic Review, American Economic Association, vol. 92(5), pages 1669-1686, December.
    11. Abdulkadiroglu, Atila & Sonmez, Tayfun, 1999. "House Allocation with Existing Tenants," Journal of Economic Theory, Elsevier, vol. 88(2), pages 233-260, October.
    12. Roth, Alvin E., 1982. "Incentive compatibility in a market with indivisible goods," Economics Letters, Elsevier, vol. 9(2), pages 127-132.
    13. 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.
    14. Atila Abdulkadiroglu & Tayfun Sönmez, 2003. "School Choice: A Mechanism Design Approach," American Economic Review, American Economic Association, vol. 93(3), pages 729-747, June.
    15. Tayfun Sonmez, 1999. "Strategy-Proofness and Essentially Single-Valued Cores," Econometrica, Econometric Society, vol. 67(3), pages 677-690, May.
    16. Alvin E. Roth, 2002. "The Economist as Engineer: Game Theory, Experimentation, and Computation as Tools for Design Economics," Econometrica, Econometric Society, vol. 70(4), pages 1341-1378, July.
    17. Ma, Jinpeng, 1994. "Strategy-Proofness and the Strict Core in a Market with Indivisibilities," International Journal of Game Theory, Springer;Game Theory Society, vol. 23(1), pages 75-83.
    18. Elliott Peranson & Alvin E. Roth, 1999. "The Redesign of the Matching Market for American Physicians: Some Engineering Aspects of Economic Design," American Economic Review, American Economic Association, vol. 89(4), pages 748-780, September.
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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C78 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Bargaining Theory; Matching Theory

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