Incentivized kidney exchange

Abstract

Over the last 15 years, kidney exchange has become a mainstream paradigm to increase transplants. However, compatible pairs do not participate, and the full benefits from exchange can be realized only if they do. We propose incentivizing compatible pairs to participate in exchange by insuring their patients against future renal failure via increased priority in the deceased-donor queue. Efficiency and equity analyses of this scheme are conducted and compared with that of kidney exchange in a new dynamic continuum model. We calibrate the model with US data and quantify substantial gains from adopting incentivized exchange in efficiency and access equity.