Abstract for: Kidney transplantations in the United States: A System Dynamics approach to reduce the waiting list and illegal trafficking

The increasing need for kidney transplants and the structural gap between kidney donation and demand is virtually a universal problem, and has been challenging policy makers in the US and worldwide for years. Although improvements for kidney procurement have been made over the years, still, on average 13 people on the waiting list die every day while awaiting a kidney transplant. At the same time, illegal kidney transplants are flourishing. In this study, an attempt was made to explore the various dynamics involved in the kidney transplant system by means of System Dynamics simulation, to identify leverage points for policy interventions and explore various policies and their effectiveness under highly uncertain conditions. Key focus was on the transplant waiting list, donor registrations, and both legal and illegal transplants performed. The model was validated in accordance with Organ Procurement and Transplantation Network Data. Simulation results showed that without intervention, problems are expected to worsen. Complementary, uncertainty analysis confirmed these results. The only policy which was found to have large enough impact to reverse the up going trend of the waiting list, is to provide financial compensation for unrelated living donors. However this policy is accompanied with many ethical issues.