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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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    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2004. "Kidney Exchange," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(2), pages 457-488.
    5. Roth, Alvin E., 2003. "The origins, history, and design of the resident match," Scholarly Articles 35059715, Harvard University Department of Economics.
    6. 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.
    7. 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.
    8. 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.
    9. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
    10. Atila Abdulkadiroglu & Tayfun Sönmez, 2003. "School Choice: A Mechanism Design Approach," American Economic Review, American Economic Association, vol. 93(3), pages 729-747, June.
    11. 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)

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    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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