Economics Department

Working Papers in Economics

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TITLE:
Efficient Kidney Exchange: Coincidence of Wants in a Structured Market

AUTHOR(S):
Alvin E. Roth, Harvard University
Tayfun Sönmez, Boston College
M. Utku Ünver, Koç University

DOCUMENT TYPE: Article

ABSTRACT:
Patients needing kidney transplants may have willing donors who cannot donate to them because of blood or tissue incompatibility. Incompatible patient-donor pairs can exchange donor kidneys with other such pairs. The situation facing such pairs resem- bles models of the ìdouble coincidence of wants,î and relatively few exchanges have been consummated by decentralized means. As the population of available patient-donor pairs grows, the frequency with which exchanges can be arranged will depend in part on how exchanges are organized. We study the potential frequency of exchanges as a function of the number of patient-donor pairs, and the size of the largest feasible exchange. Developing infrastructure to identify and perform 3-way as well as 2-way exchanges will have a substantial effect on the number of transplants, and will help the most vulnerable patients. Larger than 3-way exchanges have much smaller impact. Larger populations of patient-donor pairs increase the percentage of patients of all kinds who can find exchanges.