Designing a kidney exchange program in Germany: simulations and recommendations

Itai Ashlagi (), Ágnes Cseh (), David Manlove (), Axel Ockenfels () and William Pettersson ()
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Itai Ashlagi: Stanford University
Ágnes Cseh: University of Bayreuth
David Manlove: University of Glasgow
Axel Ockenfels: University of Cologne
William Pettersson: University of Glasgow

Central European Journal of Operations Research, 2025, vol. 33, issue 4, No 15, 1529-1555

Abstract: Abstract We examine some of the opportunities and challenges concerned with establishing a centralized national kidney exchange program in Germany. Despite the many advantages of a national program, without deliberate design and policy intervention, a fragmented kidney exchange program may emerge. We study a number of collaboration strategies, and resulting simulations suggest that transplant centers may find it advantageous not to fully participate, resulting in a net reduction in the number of transplants. These results also suggest that allowing more forms of kidney exchange, such as three-way exchanges and non-directed donations, can significantly increase the number of transplants while making participation in a national program more attractive and thus national coordination and cooperation more robust. We propose a multi-level policy approach that is easy to implement and would promote an efficient German kidney exchange program that benefits recipients, donors and hospitals.

Keywords: Kidney exchange; Market design; Simulation (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10100-024-00933-0

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