Here are a set of simulations designed to help Germany establish a national (rather than a fragmented) kidney exchange system.
Itai Ashlagi, Ágnes Cseh, David Manlove, Axel Ockenfels & William Pettersson, Designing a kidney exchange program in Germany: simulations and recommendations. Central European Journal of Operations Research (2024). https://doi.org/10.1007/s10100-024-00933-0
"Abstract: We examine some of the opportunities and challenges concerned with establishing a centralized national kidney exchange program in Germany. Despite the many advantages of a national program, without deliberate design and policy intervention, a fragmented kidney exchange program may emerge. We study a number of collaboration strategies, and resulting simulations suggest that transplant centers may find it advantageous not to fully participate, resulting in a net reduction in the number of transplants. These results also suggest that allowing more forms of kidney exchange, such as three-way exchanges and non-directed donations, can significantly increase the number of transplants while making participation in a national program more attractive and thus national coordination and cooperation more robust. We propose a multi-level policy approach that is easy to implement and would promote an efficient German kidney exchange program that benefits recipients, donors and hospitals."
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The concluding sentence of the paper is:
"Germany should establish a robust, well-functioning national KEP that can be easily and straightforwardly integrated into an international KEP."
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