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Kidney exchange programs have been developed to find compatible kidneys forrecipients who have incompatible donors. On the other hand, patients who do nothave a living donor depend upon deceased donor (DD) donations to get a kidneytransplant. Currently, in India a deceased donor donates kidneys directly to adeceased donor wait-list. The idea of initiating an exchange chain startingfrom a deceased donor kidney is proposed in a few articles (and recentlyexecuted in Italy), but no mathematical formulation has been given for thismerger. We have introduced an integer programming formulation that createsdeceased donor initiated chains, considering both paired exchange registry anddeceased donor allocations simultaneously. There is a possibility of overlapbetween paired exchange registry and deceased donor wait-list registry data asrecipients can register for both registries independently. This has also beenaddressed in the paper. A long term simulation study is done to analyze thegain of these DD initiated chains over time. It suggests that even with smallnumbers of deceased donors, these chains can increases the number of potentialtransplants significantly. Also, waiting time and dropout rates in the mergedregistry decreases substantially.

Long term simulation analysis of deceased donor initiated chains in kidney exchange programs