Kidney Exchange emerged as an exciting application of market design in the last decade. The purpose of this project is two-fold: First, it aims to increase welfare gains from kidney exchanges via a number of policies that are designed to expand kidney-exchange pools by attracting highly sought after patient-donor pairs such as pairs with blood-type O donors. The second purpose of this project is extending the tools introduced for kidney exchanges to other solid organs such as livers and lungs.

The project is based on the following four aspects of organ allocation. (1) Welfare and equity consequences of organ allocation policies and incentivizing compatible pairs to participate in kidney exchange: A new incentive scheme that relies on incentivizing participation of compatible pairs in exchange via insurance for the patient for a second future renal failure will be proposed. A new dynamic organ allocation model will be introduced. Welfare and equity analysis of this scheme will be conducted and compared with welfare and equity outcomes of live donation and live donor organ exchange. The potential role of such an incentive scheme to strengthen the national kidney exchange system will be presented. (2) Desensitization protocols and kidney exchange: One of the transplantation modalities involves desensitizing patients with antibody removing medication. In the absence of kidney exchange these protocols increase the number of transplants by removing a barrier to direct donation. A model on the impact of desensitization in the presence of kidney exchange will be introduced and analyzed. It will be shown that while blood-type desensitization increases the total number of kidney transplants, tissue-type desensitization reduces the total number of kidney transplants. (3) Blood sub-typing and kidney exchange: Blood-type A has two main sub-types, A1 and A2. In contrast to type A1 kidneys, type A2 kidneys can be donated to most type B or O patients. Since 2013, type A2 deceased donor kidneys are prioritized for type B patients under the UNOS deceased donor allocation system. A kidney exchange model that includes sub-types of blood-type A will be introduced and analyzed. It will be shown that while allowing type A2 kidneys to be donated to type O patients increases the total number of transplants, allowing type A2 kidneys to be donated to type B patients decreases this number. (4) Liver/Lung Exchange: Living donor transplants are carried out both for livers and lungs, where a lobe of these organs from a donor is transplanted to the patient. In addition to blood-type compatibility, size-compatibility is also essential for a successful transplant for both organs. Furthermore, live donor lung transplantation requires two donors for each patient where each donor donates a lung lobe to the patient. Live donor lung exchange will be proposed as a new lung transplantation modality. Models of liver exchange and lung exchange will be introduced and analyzed. Welfare gains of these organ exchanges will be simulated.

Agency
National Science Foundation (NSF)
Institute
Division of Social and Economic Sciences (SES)
Type
Standard Grant (Standard)
Application #
1426440
Program Officer
Seung-Hyun Hong
Project Start
Project End
Budget Start
2014-09-01
Budget End
2017-08-31
Support Year
Fiscal Year
2014
Total Cost
$280,247
Indirect Cost
Name
Boston College
Department
Type
DUNS #
City
Chestnut Hill
State
MA
Country
United States
Zip Code
02467