Ending the Kidney Shortage : The Effect of Kidney Paired Exchange on the Kidney Shortage in the United States

Abstract

Due to the widening kidney shortage in the United States, kidney exchange has been implemented in many hospitals and transplants centers in order to increase the number of kidney transplantations. This SIP addresses two questions regarding kidney exchange. First, to what extent do kidney exchange programs have the potential to eliminate the kidney shortage in the United States? Second, what are the important factors that contribute to gains and losses to efficiency both in kidney exchange today, and the program as it continues to expand to a level of full participation. These questions are addressed with comparative trend data and three econometric models, all of which use the STAR data file obtained from the Organ Procurement and Transplantation Network. The findings give insight into the feasibility of kidney exchange as a means of ending the kidney shortage, the implications of the blood-type composition of the donor pool and the inherent inequalities of the kidney market. Despite still being in a period of substantial growth, it is likely that kidney exchange will need to be combined with other advancements in science and policy in order to fully end the shortage. It is found that the composition of the donor pool is an important factor in maximizing kidney exchange, but due to a draining effect of type O donors, it is currently functioning under an unsustainable model. It is also found that candidates for kidneys that are non-white and that are not college educated are at a disadvantage for receiving a living donor kidney transplant.