Policy Impact of Utku Ünver's Research
Here is a simple demo of the idea behind a two-way kidney exchange
(from the Alliance for Paired Donation web-site).
Surgeon Frank Delmonico, Susan Saidman, Alvin E. Roth, Tayfun Sönmez, and
I launched New
England Program for Kidney Exchange (NEPKE)
in 2004. This is the first program that uses optimization-based mechanisms
to find kidney exchanges.
Alvin E. Roth, Tayfun Sönmez, and I also helped the launching of the Alliance for Paired Donation
(APD), founded by Dr. Michael
Rees and Jon Kopke through the funding of University of Toledo and University
of Cincinnati in Ohio. APD is a cross-country paired donation registry.
At APD, we started to implement Never-Ending-Altruistic-Donor
Chains (NEAD-Chains),
an idea that we developed with Michael Rees and Jon Kopke. Here is the Boston Globe and CNN news stories of the longest NEAD chain in history (on-going as of March 2009), which has been documented in our recent NEJM paper. Also you can watch and read CBS evening news story featuring Matt Jones, the altruistic donor of the chain, surgeon Mike Rees, and some of the patients and donors of the chain..
NEAD-chain idea is based on the fact that chain
transplants initiated by altruistic donors need not be done simultaneously.
This idea was proposed in our AJT paper.
We showed in our AER paper “Efficient
Kidney Exchange: Coincidence of Wants in Markets with Compatibility-Based
Preferences” that using
at-most 4-way exchanges, almost all gains from kidney exchange can be
exploited. Based on this, we started to implement priority mechanisms
using at most 4-way kidney exchanges in NEPKE and APD (see a related news story).
We
have also authored the optimization software currently used in NEPKE
and APD. However, solution of this optimization problem is in general
NP complete. Thus, no efficient algorithm exists to find the outcome
of our mechanisms. To handle a larger program, such as a national kidney
exchange program, we proposed David Abraham, Avrim Blum and Tuomas Sandholm
(computer scientists at CMU who are experts of designing memory efficient
algorithms) to design an algorithm to find the outcomes of our mechanisms
for larger problems. They have unveiled their
algorithm that solves our
proposals recently in 2007.
Here is the UNOS
consensus statement that
I co-authored for the implementation of a national kidney paired donation
program.
Here is the recent US
Congress Bill that clarifies
that paired kidney donations do not violate the National Organ Transplant
Act.
National Science Foundation web-published a story called “Kidney Exchange: A Life-Saving
Application of Matching Theory”
about my research with Alvin E. Roth and Tayfun Sönmez on Kidney Exchange.
Tim Harford published a story in the Financial
Times on 7/14/2007 about
our work.
Steven Levitt and Stephen Dubner wrote a story citing our work on their Freakonomics column in the New York Times Magazine on 7/9/2006.
An article titled "Easing
the Kidney Shortage"
from the Wall Street Journal (6/17/2004) describes the basics of our
kidney exchange system and outlines that New England region is considering
establishment of a cross-donor database and adoption of a version of
our proposed mechanism to carry out kidney exchanges among transplant
patient-donor pairs.
Also see another article titled "Cross-donor system planned
for region's kidney patients"
from the Boston Globe (6/5/2004) on the same subject.
SIAM News also published an
article about our paper
in their June, 2004 issue.
Our proposals on organization of kidney exchange have been finding
real life applications in other transplant centers, as well:
In our JET paper “Pairwise
Kidney Exchange”, besides
our mechanism design approach, we propose using combinatorial optimization
and graph theoretic techniques developed by Edmonds (1965) on organizing
kidney exchanges. After we published ‘Pairwise Kidney Exchange’
as an NBER working paper in the summer of 2004, Johns Hopkins team published
a paper in 2005 in the Journal of American Medical Association with
simulations using the generalized version of Edmonds’ (1965) algorithm
that we proposed in ‘Pairwise Kidney Exchange’. Consequently, Johns
Hopkins University Transplant Center adopted a pairwise kidney exchange
scheme based on Edmonds’
algorithm.
In our QJE paper “Kidney
Exchange”, we propose
the idea of a “w-chain exchange.” Non-directed donor chain exchanges
are based on the same idea, and this second idea was developed by Johns
Hopkins. Recently, Johns Hopkins University conducted the first 5-way non-directed
donor chain exchange, in
which a non-directed altruistic donor donates a kidney to the patient
of the first pair, the donor of the first pair donates a kidney to the
patient of the second pair, the donor of the second pair donates a kidney
to the patient of the third pair, the donor of the third pair donates
a kidney to the patient of the fourth pair, and finally the donor of
the fourth pair donates a kidney to a waiting list patient without a
donor.
On 10/23/2008, the popular TV medical drama "Grey's Anatomy" featured a 6-way simultaneous altruistic donor chain and emphasized the ethical and institutional constraints associated with the chain. Here you can read its synopsis and watch the episode.