title: Utilizing list exchange and nondirected donation through 'chain' paired kidney donations.
abstract: In a list exchange (LE), the intended recipient in an incompatible pair receives priority on the deceased donor waitlist (DD-waitlist) after the paired incompatible donor donates a kidney to a DD-waitlist candidate. A nondirected donor's (ND-D) kidney is usually transplanted directly to a DD-waitlist candidate. These two established practices would help even more transplant candidates if they were integrated with kidney paired donation (KPD). We consider a scenario in which the donor of an LE intended recipient (LE-IR) donates to a compatible KPD intended recipient (KPD-IR), and the KPD donor (KPD-D) donates to the waitlist (an LE-chain). We consider a similar scenario in which an ND-D donates to a KPD-IR and the KPD-D donates to the DD-waitlist (an ND-chain). Using data derived from the New England Program for Kidney Exchange (NEPKE) and from OPTN/SRTR recipient-donor distributions, simulations are presented to evaluate the potential impact of chain exchanges coordinated with KPD. LE donors (LE-D) and ND-D who are ABO-O result in the highest number of additional transplants, while results for ABO-A and B donors are similar to each other. We recommend that both LE and ND donations be utilized through chain exchanges.
authors.affiliation: Harvard University, Department of Economics, Cambridge, Massachusetts and Harvard Business School, Boston, Massachusetts, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Roth
authors.forename: T
authors.initials: T
authors.lastname: Sönmez
authors.forename: M U
authors.initials: MU
authors.lastname: Unver
authors.forename: F L
authors.initials: FL
authors.lastname: Delmonico
authors.forename: S L
authors.initials: SL
authors.lastname: Saidman
mesh_terms: D000017:ABO Blood-Group System; D001787:Blood Group Incompatibility; D003198:Computer Simulation; D006801:Humans; D007668:Kidney; D016030:Kidney Transplantation / Q000276:immunology*; D007983:Lewis Blood Group Antigens; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000379:methods*; D014850:Waiting Lists
chemical_list: D000017:ABO Blood-Group System; D007983:Lewis Blood Group Antigens