Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited
Since 2008, kidney exchange in America has grown in part from the incorporation of nondirected donors in transplant chains rather than simple exchanges. It is controversial whether these chains should be performed simultaneously ‘domino-paired donation’, (DPD) or nonsimultaneously ‘nonsimultaneous e...
| Main Authors: | , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | en_US |
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Wiley
2011
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| Online Access: | http://hdl.handle.net/1721.1/64805 https://orcid.org/0000-0003-2124-738X |
| _version_ | 1826192360216723456 |
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| author | Ashlagi, Itai Gilchrist, D. S. Roth, A. E. Rees, M. A. |
| author2 | Sloan School of Management |
| author_facet | Sloan School of Management Ashlagi, Itai Gilchrist, D. S. Roth, A. E. Rees, M. A. |
| author_sort | Ashlagi, Itai |
| collection | MIT |
| description | Since 2008, kidney exchange in America has grown in part from the incorporation of nondirected donors in transplant chains rather than simple exchanges. It is controversial whether these chains should be performed simultaneously ‘domino-paired donation’, (DPD) or nonsimultaneously ‘nonsimultaneous extended altruistic donor, chains (NEAD). NEAD chains create ‘bridge donors’ whose incompatible recipients receive kidneys before the bridge donor donates, and so risk reneging by bridge donors, but offer the opportunity to create more transplants by overcoming logistical barriers inherent in simultaneous chains. Gentry et al. simulated whether DPD or NEAD chains would produce more transplants when chain segment length was limited to three transplants, and reported that DPD performed at least as well as NEAD chains. As this finding contrasts with the experience of several groups involved in kidney-paired donation, we performed simulations that allowed for longer chain segments and used actual patient data from the Alliance for Paired Donation. When chain segments of 4–6 transplants are allowed in the simulations, NEAD chains produce more transplants than DPD. Our simulations showed not only more transplants as chain length increased, but also that NEAD chains produced more transplants for highly sensitized and blood type O recipients. |
| first_indexed | 2024-09-23T09:10:37Z |
| format | Article |
| id | mit-1721.1/64805 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T09:10:37Z |
| publishDate | 2011 |
| publisher | Wiley |
| record_format | dspace |
| spelling | mit-1721.1/648052022-09-30T13:55:28Z Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited Ashlagi, Itai Gilchrist, D. S. Roth, A. E. Rees, M. A. Sloan School of Management Ashlagi, Itai Ashlagi, Itai Since 2008, kidney exchange in America has grown in part from the incorporation of nondirected donors in transplant chains rather than simple exchanges. It is controversial whether these chains should be performed simultaneously ‘domino-paired donation’, (DPD) or nonsimultaneously ‘nonsimultaneous extended altruistic donor, chains (NEAD). NEAD chains create ‘bridge donors’ whose incompatible recipients receive kidneys before the bridge donor donates, and so risk reneging by bridge donors, but offer the opportunity to create more transplants by overcoming logistical barriers inherent in simultaneous chains. Gentry et al. simulated whether DPD or NEAD chains would produce more transplants when chain segment length was limited to three transplants, and reported that DPD performed at least as well as NEAD chains. As this finding contrasts with the experience of several groups involved in kidney-paired donation, we performed simulations that allowed for longer chain segments and used actual patient data from the Alliance for Paired Donation. When chain segments of 4–6 transplants are allowed in the simulations, NEAD chains produce more transplants than DPD. Our simulations showed not only more transplants as chain length increased, but also that NEAD chains produced more transplants for highly sensitized and blood type O recipients. Alliance for Paired Donation Novartis (Firm) Genzyme Corporation F. Hoffmann-La Roche & Co. Pfizer Inc. Astellas Pharma US National Science Foundation (U.S.) (Grant No. 0616733 to the National Bureau of Economic Research) Life Connection of Ohio University of Toledo 2011-07-14T14:43:45Z 2011-07-14T14:43:45Z 2011-05 2011-02 Article http://purl.org/eprint/type/JournalArticle 1600-6143 1600-6135 http://hdl.handle.net/1721.1/64805 Ashlagi, I. et al. “Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited.” American Journal of Transplantation 11.5 (2011) : 984-994. https://orcid.org/0000-0003-2124-738X en_US http://dx.doi.org/10.1111/j.1600-6143.2011.03481.x American Journal of Transplantation Creative Commons Attribution-Noncommercial-Share Alike 3.0 http://creativecommons.org/licenses/by-nc-sa/3.0/ application/pdf Wiley MIT web domain |
| spellingShingle | Ashlagi, Itai Gilchrist, D. S. Roth, A. E. Rees, M. A. Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title | Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title_full | Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title_fullStr | Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title_full_unstemmed | Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title_short | Nonsimultaneous Chains and Dominos in Kidney- Paired Donation—Revisited |
| title_sort | nonsimultaneous chains and dominos in kidney paired donation revisited |
| url | http://hdl.handle.net/1721.1/64805 https://orcid.org/0000-0003-2124-738X |
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