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Eliminating transplant waiting time inequities – With an application to kidney allocation in the USA

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  • van de Klundert, Joris
  • van der Hagen, Liana
  • Markus, Aniek

Abstract

Inequities in waiting times for deceased donor organ transplantation have received considerable attention in the last three decades and have motivated allocation policy reforms. This holds particularly true for kidney transplantation in the United States, where more than 90,000 patients are wait listed and average waiting times vary considerably among patients from different blood types and ethnic groups. This research presents a novel approach to formally model, analyze, and optimize equity of transplant waiting times and probabilities using queuing models, network flows, and Rawls’ Theory of Justice. The presented formal models address inequities resulting from blood type incompatibilities, which are interrelated to ethnic differences in patient and donor rates. Moreover, we present results of an application to the deceased donor kidney wait lists in the United States. The findings indicate that the allocation policies currently practiced red can virtually resolve blood type related inequities in average waiting time and transplant probability.

Suggested Citation

  • van de Klundert, Joris & van der Hagen, Liana & Markus, Aniek, 2022. "Eliminating transplant waiting time inequities – With an application to kidney allocation in the USA," European Journal of Operational Research, Elsevier, vol. 297(3), pages 977-985.
    • Handle: RePEc:eee:ejores:v:297:y:2022:i:3:p:977-985
    DOI: 10.1016/j.ejor.2021.09.033
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    References listed on IDEAS

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    1. Tayfun Sönmez & M. Utku Ünver, 2015. "Enhancing the Efficiency of and Equity in Transplant Organ Allocation via Incentivized Exchange," Boston College Working Papers in Economics 868, Boston College Department of Economics.
    2. Stefanos A. Zenios & Glenn M. Chertow & Lawrence M. Wein, 2000. "Dynamic Allocation of Kidneys to Candidates on the Transplant Waiting List," Operations Research, INFORMS, vol. 48(4), pages 549-569, August.
    3. Scott Duke Kominers & Parag A. Pathak & Tayfun Sönmez & M. Utku Ünver, 2020. "Paying It Backward and Forward: Expanding Access to Convalescent Plasma Therapy Through Market Design," Boston College Working Papers in Economics 1007, Boston College Department of Economics.
    4. Hanan Luss, 1999. "On Equitable Resource Allocation Problems: A Lexicographic Minimax Approach," Operations Research, INFORMS, vol. 47(3), pages 361-378, June.
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