Matching Kidneys with Priority in Kidney Exchange Programs

Wenhao Liu and Marc L. Melcher
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Wenhao Liu: Salesforce.com, Inc.
Marc L. Melcher: Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA

Medical Decision Making, 2019, vol. 39, issue 4, 336-346

Abstract: Kidney exchanges were developed to match kidney failure patients with willing but incompatible donors to other donor-patient pairs. Finding a match in a large candidate pool can be modeled as an integer program. However, these exchanges accumulate participants with characteristics that increase the difficulty of finding a match and, therefore, increase patients’ waiting time. Therefore, we sought to fine-tune the formulation of the integer program by more accurately assigning priorities to patients based on their difficulty of matching. We provide a detailed formulation of prioritized kidney exchange and propose a novel prioritization algorithm. Our approach takes advantage of the global knowledge of the donor-patient compatibility within a pool of pairs and calculates an iterative, paired match power (iPMP) to represent the donor-patient pairs’ abilities to match. Monte Carlo simulation shows that an algorithm using the iPMP reduces the waiting time more than using paired match power (PMP) for the difficult-to-match pairs with hazard ratios of 1.3480 and 1.1100, respectively. Thus, the iPMP may be a more accurate assessment of the difficulty of matching a pair in a pool than PMP is, and its use may improve matching algorithms being used to match donors and recipients.

Keywords: kidney transplantation; kidney exchange; kidney paired donation; patient priority; Monte Carlo simulation (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:4:p:336-346

DOI: 10.1177/0272989X19849457

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