Property rights inmulti-centered organ exchanged
Abstract:
Organs for transplantation are a scarce resource. In organ allocation, one promising avenue to educe waste and improve efficiency is cross-border exchange programs for deceased-donor organs. Since countries view their deceased-donor organs as national endowments, cross-border efforts can gain traction only if property rights for national organ supplies are respected. In a model of organ exchange with multiple centers (or nations), we propose two intuitive property rights axioms: queuewise rationality, an elementary condition, and the core, a more stringent requirement. We find that based on our property rights axioms, the most promising rule is the top trading cycles: It is the unique rule which is pair-efficient, queuewise-rational and strategy-proof, and it finds the unique core allocation. We also find that under autarky conditions the most promising solution is the autarkic priority rule: It is the unique autarkic rule which is queuewise rational and strategy-proof; it finds the unique autarkic core allocation; and it is not Pareto dominated by any strategy-proof and pair-efficient rule.