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Increasing the Opportunity of Live Kidney Donation by Matching for Two and Three Way Exchanges

Author

Listed:
  • Saidman, Susan L.
  • Roth, Alvin E.
  • Sonmez, Tayfun
  • Unver, M. Utku
  • Delmonico, Francis L.

Abstract

Background: To expand the opportunity for paired live donor kidney transplantation, computerized matching algorithms have been designed to identify maximal sets of compatible donor/recipient pairs from a registry of incompatible pairs submitted as candidates for transplantation. Methods: Demographic data of patients who had been evaluated for live donor kidney transplantation but found to be incompatible with their potential donor (because of ABO blood group or positive crossmatch) were submitted for computer analysis and matching. Data included ABO and HLA types of donor and recipient, %PRA and specificity of recipient alloantibody, donor/recipient relationship, and the reason the donor was incompatible. The data set used for the initial simulation included 29 patients with one donor each and 16 patients with multiple donors for a total of 45 patients and 68 donor/patient pairs. In addition, a simulation based on OPTN/SRTR data was used to further assess the practical importance of multiple exchange combinations. Results: If only exchanges involving two patient-donor pairs were allowed, a maximum of 8 patient-donor pairs in the data set could exchange kidneys. If 3-way exchanges were also allowed, a maximum of 11 pairs could exchange kidneys. Simulations with OPTN/SRTR data demonstrate that the increase in the number of potential transplants if 3-way exchanges are allowed is robust, and does not depend on the particular patients in our sample. Conclusions: A computerized matching protocol can be used to identify donor/recipient pairs from a registry of incompatible pairs who can potentially enter into donor exchanges that otherwise would not readily occur.

Suggested Citation

  • 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.
  • Handle: RePEc:pra:mprapa:58247
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    File URL: https://mpra.ub.uni-muenchen.de/58247/1/MPRA_paper_58247.pdf
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    References listed on IDEAS

    as
    1. Tayfun Sönmez & Alvin E. Roth & M. Utku Ünver, 2007. "Efficient Kidney Exchange: Coincidence of Wants in Markets with Compatibility-Based Preferences," American Economic Review, American Economic Association, vol. 97(3), pages 828-851, June.
    2. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
    3. Atila Abdulkadiroğlu & Parag A. Pathak & Alvin E. Roth, 2005. "The New York City High School Match," American Economic Review, American Economic Association, vol. 95(2), pages 364-367, May.
    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. Zenios, Stefanos & Woodle, E. Steve & Ross, Lainie Friedman, 2001. "Primum Non Nocere: Avoiding Harm to Vulnerable Wait List Candidates in an Indirect Kidney Exchange," Research Papers 1684, Stanford University, Graduate School of Business.
    6. Alvin E. Roth & Tayfun Sönmez, 2005. "A Kidney Exchange Clearinghouse in New England," American Economic Review, American Economic Association, vol. 95(2), pages 376-380, May.
    7. Atila Abdulkadiroğlu & Parag A. Pathak & Alvin E. Roth & Tayfun Sönmez, 2005. "The Boston Public School Match," American Economic Review, American Economic Association, vol. 95(2), pages 368-371, May.
    8. Atila Abdulkadiroglu & Tayfun Sönmez, 2003. "School Choice: A Mechanism Design Approach," American Economic Review, American Economic Association, vol. 93(3), pages 729-747, June.
    9. Roth, Alvin E, 1984. "The Evolution of the Labor Market for Medical Interns and Residents: A Case Study in Game Theory," Journal of Political Economy, University of Chicago Press, vol. 92(6), pages 991-1016, December.
    10. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. Committee, Nobel Prize, 2012. "Alvin E. Roth and Lloyd S. Shapley: Stable allocations and the practice of market design," Nobel Prize in Economics documents 2012-1, Nobel Prize Committee.
    2. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2005. "Efficient Kidney Exchange: Coincidence of Wants in a Structured Market," Boston College Working Papers in Economics 621, Boston College Department of Economics.
    3. Sönmez, Tayfun & Ünver, M. Utku, 2014. "Altruistically unbalanced kidney exchange," Journal of Economic Theory, Elsevier, vol. 152(C), pages 105-129.
    4. Kessler, Judd B. & Roth, Alvin E., 2014. "Loopholes undermine donation: An experiment motivated by an organ donation priority loophole in Israel," Journal of Public Economics, Elsevier, vol. 114(C), pages 19-28.
    5. Alvin E. Roth, 2009. "What Have We Learned from Market Design?," Innovation Policy and the Economy, University of Chicago Press, vol. 9(1), pages 79-112.
    6. Glorie, K.M. & Wagelmans, A.P.M. & van de Klundert, J.J., 2012. "Iterative branch-and-price for hierarchical multi-criteria kidney exchange," Econometric Institute Research Papers EI 2012-11, Erasmus University Rotterdam, Erasmus School of Economics (ESE), Econometric Institute.
    7. Judd B. Kessler & Alvin E. Roth, 2012. "Organ Allocation Policy and the Decision to Donate," American Economic Review, American Economic Association, vol. 102(5), pages 2018-2047, August.
    8. Paarsch, Harry J. & Segre, Alberto M. & Roberts, John P. & Halldorson, Jeffrey B., 2011. "Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System," CIS Discussion paper series 522, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    9. repec:pal:jorsoc:v:68:y:2017:i:12:d:10.1057_s41274-016-0174-3 is not listed on IDEAS
    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. Alvin E. Roth, 2012. "Marketplace Institutions Related to the Timing of Transactions: Reply to Priest," Journal of Labor Economics, University of Chicago Press, vol. 30(2), pages 479-494.
    12. Toulis, Panos & Parkes, David C., 2015. "Design and analysis of multi-hospital kidney exchange mechanisms using random graphs," Games and Economic Behavior, Elsevier, vol. 91(C), pages 360-382.
    13. Judd B. Kessler & Alvin E. Roth, 2014. "Don't Take 'No' For An Answer: An Experiment With Actual Organ Donor Registrations," NBER Working Papers 20378, National Bureau of Economic Research, Inc.
    14. Murat Kurt & Mark S. Roberts & Andrew J. Schaefer & M. Utku Ünver, 2011. "Valuing Prearranged Paired Kidney Exchanges: A Stochastic Game Approach," Boston College Working Papers in Economics 785, Boston College Department of Economics, revised 14 Oct 2011.
    15. Roth, Alvin E. & Ashlagi, Itai, 2014. "Free riding and participation in large scale, multi-hospital kidney exchange," Theoretical Economics, Econometric Society, vol. 9(3), September.
    16. Roth, Alvin E. & Sonmez, Tayfun & Unver, Utku & Delmonico, Francis & Saidman, Susan L., 2014. "Utilizing List Exchange and Non-directed Donation through “Chain” Paired Kidney Donations," MPRA Paper 58246, University Library of Munich, Germany.
    17. Constantino, Miguel & Klimentova, Xenia & Viana, Ana & Rais, Abdur, 2013. "New insights on integer-programming models for the kidney exchange problem," European Journal of Operational Research, Elsevier, vol. 231(1), pages 57-68.
    18. Andersson, Tommy & Kratz, Jörgen, 2016. "Kidney Exchange over the Blood Group Barrier," Working Papers 2016:11, Lund University, Department of Economics, revised 29 Nov 2017.
    19. Tayfun Sönmez & Alvin E. Roth & M. Utku Ünver, 2007. "Efficient Kidney Exchange: Coincidence of Wants in Markets with Compatibility-Based Preferences," American Economic Review, American Economic Association, vol. 97(3), pages 828-851, June.
    20. Itai Ashlagi & Alvin E. Roth, 2011. "Individual Rationality and Participation in Large Scale, Multi-Hospital Kidney Exchange," NBER Working Papers 16720, National Bureau of Economic Research, Inc.
    21. Alvin E. Roth, 2010. "Marketplace Institutions Related to the Timing of Transactions," NBER Working Papers 16556, National Bureau of Economic Research, Inc.
    22. Glorie, K.M., 2012. "Estimating the probability of positive crossmatch after negative virtual crossmatch," Econometric Institute Research Papers EI 2012-25, Erasmus University Rotterdam, Erasmus School of Economics (ESE), Econometric Institute.
    23. repec:oup:oxford:v:33:y:2017:i:4:p:676-704. is not listed on IDEAS
    24. Tayfun Sönmez & M Utku Ünver, 2017. "Market design for living-donor organ exchanges: an economic policy perspective," Oxford Review of Economic Policy, Oxford University Press, vol. 33(4), pages 676-704.

    More about this item

    Keywords

    Kidney Exchange;

    JEL classification:

    • C78 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Bargaining Theory; Matching Theory
    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design

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