Kidney exchange: An egalitarian mechanism

Transplantation is the preferred treatment for the most serious forms of kidney disease; deceaseddonor and live-donor kidneys are the two sources for transplantation, and these sources are utilized via two different programs. One of these programs, a two-way kidney paired donation (KPD), involves two patient-donor couples, for each of whom transplantation from donor to intended recipient is not possible due to medical incompatibilities, but such that the patient in each couple could receive a transplant from the donor in the other couple. This pair of couples can then exchange donated kidneys. Another possibility is a list exchange (LE) : a living incompatible donor provides a kidney to a candidate on the deceased-donor (DD) waitlist and in return the intended recipient of this donor receives a priority on the DD-waitlist. In this work, we explore how to organize such exchanges by integrating the KPD’s and LE’s, and taking into consideration the fact that transplants from live donors have a higher chance of success than those from cadavers. Our contribution is the characterization of the set of efficient and egalitarian exchanges involving the KPD’s and LE’s.