#21 2004 · New England Program for Kidney Exchange · Organ transplantation
Economists chained incompatible donors until every kidney found its match
the problem
Willing donors, wrong blood types
background
In 2003 roughly 60,000 Americans were waiting for a kidney; only 8,665 deceased-donor transplants happened that year, and 3,436 people died waiting. Live donation could fill some of the gap — a healthy person has two kidneys and can live with one — except that a willing donor is frequently the wrong blood type or tissue match for the specific patient they love, and money cannot legally fix that: buying or selling organs is illegal everywhere transplant medicine is regulated.
A handful of hospitals had begun swapping kidneys between two incompatible pairs — my incompatible donor gives to your patient, yours gives to mine — and Johns Hopkins had even managed a few three-way versions. But as of December 2004 only five such exchanges had happened across all fourteen transplant centers in New England, because no one had built a database of incompatible pairs to match against; unmatched donors were simply sent home.
the move
Economists applied matching theory to incompatible donor-patient pairs, later extended into long non-simultaneous chains.
the payoff
Thousands of transplants that could not otherwise happen; the 2012 economics Nobel cited the work.
what came after
In September 2004 the Renal Transplant Oversight Committee of New England approved a formal kidney-exchange clearinghouse, proposed jointly by transplant physicians Francis Delmonico and Susan Saidman and economists Alvin Roth, Tayfun Sönmez and Utku Ünver — turning an ad hoc, five-exchange-a-year practice into a designed market. The matching mechanism the economists built later extended beyond simple pairs into long donation chains kicked off by altruistic donors, and Roth shared the 2012 Nobel Memorial Prize in Economic Sciences for this and related market-design work.
filed under
references
- [1]A Kidney Exchange Clearinghouse in New EnglandRoth, Sönmez & Ünver (American Economic Review Papers and Proceedings), 2005tayfunsonmez.net
- [2]Roth shares economics NobelHarvard Gazette, 2012news.harvard.edu