Working Paper | 2011

Individual Rationality and Participation in Large Scale, Multi-Hospital Kidney Exchange

by Itai Ashlagi and Alvin E. Roth


As multi-hospital kidney exchange clearinghouses have grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals have the option of enrolling only their hard-to-match patient-donor pairs, while conducting easily arranged exchanges internally. This behavior has already started to be observed. We show that the cost of making it individually rational for hospitals to participate fully is low in almost every large exchange pool (although the worst-case cost is very high), while the cost of failing to guarantee individually rational allocations could be large, in terms of lost transplants. We also identify an incentive compatible mechanism.

Keywords: Health Care and Treatment; Resource Allocation; Market Participation; Marketplace Matching; Organizations; Networks; Motivation and Incentives; Health Industry;


Ashlagi, Itai, and Alvin E. Roth. "Individual Rationality and Participation in Large Scale, Multi-Hospital Kidney Exchange." NBER Working Paper Series, No. 16720, January 2011.