Enhancing the Efficiency of and Equity in Transplant Organ Allocation via Incentivized Exchange

Abstract

Within the last decade kidney exchange has become a mainstream paradigm to increase the number of kidney transplants. However, compatible pairs do not participate, and the full benefit from exchange can be realized only if they do. In this paper, we propose a new incentive scheme that relies on incentivizing participation of compatible pairs in exchange via insurance for the patient for a future renal failure. Efficiency and equity analyses of this scheme are conducted and compared with efficiency and equity outcomes of live donation and living donor organ exchange. We also present the potential role of such an incentive scheme to strengthen the national kidney exchange system.