Eliminating Waste in Cadaveric Organ Allocation

Abstract

There is a shortage in the supply of cadaveric organs in most countries, but many successfully procured and medically tenable organs are currently being discarded. This wastage of cadaveric organs exacerbates the shortage in organ supply and the financial strains on healthcare systems. Many reforms have been or are currently being implemented to address the wastage problem. However, we show that waste will still be a problem as long as the allocation mechanism continues to prioritize patients by their waiting times, which incentivizes patients to reject organs of reasonable quality now to wait for better offers in the future. Such waiting is risky, as the patients' health conditions may deteriorate while they wait, and they may no longer be fit to receive transplants when the ideal offers come. Through analyzing a theoretical model, we show that the necessary and sufficient conditions to eliminating waste are to disincentivize waiting by allocating over-demanded organ types only to the patients who recently signed up for transplantation, and to give the patients who are not allocated their ideal organs an opportunity to take another offer. However, such a policy may be contentious as it no longer prioritizes patients by waiting times. Moreover, it may reduce the welfare of the patients who are most willing to wait. The benefits of eliminating waste should be weighed against these costs when making policy decisions.

Note:
Funding Information: None to declare.

Declaration of Interests: None to declare.

Keywords: market design; matching markets; organ allocation; wait-list

JEL Classification: D47, C78