Kidney exchange reduces demographic disparities, by Bethany Lemont and Keith Teltser

 Here's an interesting recent paper on the differential impact of kidney exchange on different demographic groups...

Does Paired Kidney Exchange Reduce Demographic Disparities in Transplant Outcomes? by Bethany Lemont, Ohio University - Department of Economics, and Keith Teltser, Georgia State University, November 16, 2024

Abstract
Paired kidney exchange programs increase living donor transplants by facilitating matches across immunologically incompatible patient-donor pairs. Given existing concerns about demographic disparities in transplant access and outcomes, we examine the extent to which exchange differentially impacts patients across demographic groups. To estimate causal relationships, we leverage the importance of patient proximity to exchange-facilitating centers and plausibly exogenous spatial and temporal variation in exchange activity. We show that exchange increases the quantity of living donor transplants, improves transplant survival, and reduces waiting time overall. Patients who are Black, younger, more-educated, privately-insured, and women experience the largest living donor transplant gains in percentage terms. Patients who are Black, younger, less-educated, insured by Medicaid, and women experience the largest improvements in survival. Our findings paint a nuanced picture. Kidney exchange seems to narrow gender and racial/ethnic gaps in transplantation, exacerbate disparities by age, and have mixed effects across education and insurance groups.