Do Kidney Exchanges Improve Patient Outcomes?

Abstract

In this paper, I estimate the number of additional transplants generated by kidney exchanges. To do this, I analyze substitution patterns between exchange transplants and other transplant outcomes. Exploiting variation in patients exposure to exchange activity across time and place, I find that 64 percent of exchange transplants represent new living donor transplants. Using the same approach, I find that an increase in the probability of receiving an exchange transplant reduces the probability of graft failure and reduces time spent waiting for a kidney. Back-of-the-envelope calculations suggest that each exchange transplant increases social welfare by $300,000 to $700,000. (JEL D47, I11, I12, I18)