Incorporating Compatible Pairs in Kidney Exchange: A Dynamic Weighted Matching Model
Incorporating Compatible Pairs in Kidney Exchange: A Dynamic Weighted Matching Model
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DOI：
10.1145/3328526.3329619
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发表时间：
2019-06
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影响因子：
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通讯作者：
Zhuoshu Li;Kelsey Lieberman;William Macke;Sofia Carrillo;Chien-Ju Ho;J. Wellen;Sanmay Das
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文献类型：
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作者：
Zhuoshu Li;Kelsey Lieberman;William Macke;Sofia Carrillo;Chien-Ju Ho;J. Wellen;Sanmay Das
从市场设计的角度对肾脏交换进行了广泛的研究，并将重点放在寻找链和周期的更好算法上，以增加可能匹配的数量。将相容的配对纳入该机制可能会带来更显著的好处，但这种可能性的研究相对较少。为了激励相容的配对参与交换，他们必须为接收者提供更高质量的匹配，并且可以在不增加额外等待时间的情况下执行。在本文中，我们对在交换中并入相容对的研究做出了两个主要贡献。首先，我们利用最近提出的活体供者肾脏概况指数(LKDPI)来衡量配对质量，并开发了一个新的模拟器(基于来自一家主要移植中心的数据)，用于在配对之间联合分布配型和质量。该模拟器允许我们研究在不同模型和假设下包含兼容对的好处。其次，我们引入了一个混合的在线/批量匹配模型，其中包含不耐烦(兼容)和患者(不兼容)对，以满足对即时性的需求。在该模型中，我们引入了新的匹配算法，其中包括一种基于在线原对偶技术的匹配算法。总体而言，我们的结果表明，在增加不相容配对的移植数量(几乎是移植数量的两倍)以及改善配对相容的受体的配型质量(将移植物的预期存活率提高1至2年)方面，我们的结果都具有巨大的潜力。这一结果对难以匹配的亚群也是有希望的，包括O型血型接受者。
Kidney exchange has been studied extensively from the perspective of market design, and a significant focus has been on better algorithms for finding chains and cycles to increase the number of possible matches. A more dramatic benefit could come from incorporating compatible pairs into the mechanism, but this possibility has been relatively understudied. In order to incentivize a compatible pair to participate in exchange, they must be offered a higher quality match for the recipient that can be performed without adding extra waiting time. In this paper, we make two main contributions to the study of incorporating compatible pairs in exchanges. First, we leverage the recently proposed Living Donor Kidney Profile Index (LKDPI) to measure match quality, and develop a novel simulator (based on data from a major transplant center) for the joint distribution of compatibility and quality across pairs. This simulator allows us to study the benefits of including compatible pairs under different models and assumptions. Second, we introduce a hybrid online/batch matching model with impatient (compatible) and patient (incompatible) pairs to capture the need for immediacy. We introduce new algorithms for matching in this model, including one based on online primal-dual techniques. Overall, our results indicate great potential in terms of both increased numbers of transplants of incompatible pairs (almost doubling the number transplanted) as well as improved match quality for recipients in compatible pairs (increasing expected graft survival by between 1 and 2 years). The results are also promising for hard-to-match subpopulations, including blood group O recipients.