Kidney exchange
Kidney exchange
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DOI：
10.1162/0033553041382157
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发表时间：
2004-05-01
影响因子：
13.7
通讯作者：
Ünver, MU
中科院分区：
文献类型：
--
作者：
Roth, AE;Sönmez, T;Ünver, MU
大多数移植的肾脏来自身体，但也有许多来自活体捐赠者的移植。最近，开始有两对捐赠者和患者进行肾脏交换，由于免疫不相容，每个捐赠者不能将肾脏捐赠给预期的接受者，但每个患者可以从另一个捐赠者那里获得肾脏。还进行交换，捐赠者和患者配对向等待身体肾脏的人捐赠，以换取配对中的患者在有匹配的身体肾脏可用时获得高优先权。对于如何进行交流，有严格的法律/伦理限制。我们探讨了如何在现有的约束条件下，有效地安排这些类型的更大规模的交易所，并以兼容的方式进行激励。这个问题类似于机构设计文献中研究的一些不可分商品的“住房”问题，其新颖的特点是，虽然活体捐赠者的肾脏可以同时分配，但身体肾脏不能。除了研究拟议的肾脏交换的理论性质外，我们还提供了模拟结果，表明更大规模的交换将在增加可行的活体捐赠移植数量和改善移植肾脏的匹配质量方面获得可观的福利收益。
Most transplanted kidneys are from cadavers, but there are also many transplants from live donors. Recently, there have started to be kidney exchanges involving two donor-patient pairs such that each donor cannot give a kidney to the intended recipient because of immunological incompatibility, but each patient can receive a kidney from the other donor. Exchanges are also made in which a donor-patient pair makes a donation to someone waiting for a cadaver kidney, in return for the patient in the pair receiving high priority for a compatible cadaver kidney when one becomes available. There are stringent legal/ethical constraints on how exchanges can be conducted. We explore how larger scale exchanges of these kinds can be arranged efficiently and incentive compatibly, within existing constraints. The problem resembles some of the "housing" problems studied in the mechanism design literature for indivisible goods, with the novel feature that while live donor kidneys can be assigned simultaneously, cadaver kidneys cannot. In addition to studying the theoretical properties of the proposed kidney exchange, we present simulation results suggesting that the welfare gains from larger scale exchange would be substantial, both in increased number of feasible live donation transplants, and in improved match quality of transplanted kidneys.