运输意味着移植吗?新航线对共用尸体肾脏的影响

Guihua Wang, Ronghuo Zheng, Tinglong Dai
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引用次数: 6

摘要

每年,近5000名患者在等待肾脏移植的过程中死亡,而估计有3500个获得的肾脏被丢弃。这种极度匮乏和大量浪费的两极化共存,主要是由于不同地理区域的尸体肾脏汇集不足造成的。尽管许多政策举措旨在扩大器官共享,但它们很少考虑到一个关键的摩擦效率航空运输,理想的直航,对于长距离共享是必要的,因为肾脏移植具有时间敏感性。可以想象,移植中心可能不愿意接受来自没有直飞航班的遥远地区的肾脏。在本文中,我们估计了新航线的引入对更广泛的肾脏共享的影响。通过合并美国航空运输和肾脏移植数据集,我们创建了一个独特的样本,跟踪(1)连接美国所有机场的航线演变;(2)通过这些机场连接的供体和受者之间的肾脏移植。我们估计,新航线的引入将使共享肾脏的数量增加7.3%。我们还发现,随着新路线的引入,肾脏移植总数的净增加和器官丢弃率的下降。值得注意的是,移植后的存活率基本保持不变,尽管在引入新的航线后,平均旅行距离增加了。我们的结果对其他经验规范是稳健的,对改善美国器官移植系统的可及性具有重要意义。本文被运营管理专业的Vishal Gaur接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does Transportation Mean Transplantation? Impact of New Airline Routes on Sharing of Cadaveric Kidneys
Every year, nearly 5,000 patients die while waiting for kidney transplants, and yet an estimated 3,500 procured kidneys are discarded. Such a polarized coexistence of dire scarcity and massive wastefulness has been mainly driven by insufficient pooling of cadaveric kidneys across geographic regions. Although numerous policy initiatives are aimed at broadening organ pooling, they rarely account for a key friction—efficient airline transportation, ideally direct flights, is necessary for long-distance sharing, because of the time-sensitive nature of kidney transplantation. Conceivably, transplant centers may be reluctant to accept kidney offers from far-off locations without direct flights. In this paper, we estimate the effect of the introduction of new airline routes on broader kidney sharing. By merging the U.S. airline transportation and kidney transplantation data sets, we create a unique sample tracking (1) the evolution of airline routes connecting all the U.S. airports and (2) kidney transplants between donors and recipients connected by these airports. We estimate the introduction of a new airline route increases the number of shared kidneys by 7.3%. We also find a net increase in the total number of kidney transplants and a decrease in the organ discard rate with the introduction of new routes. Notably, the posttransplant survival rate remains largely unchanged, although average travel distance increases after the introduction of new airline routes. Our results are robust to alternative empirical specifications and have important implications for improving access to the U.S. organ transplantation system. This paper was accepted by Vishal Gaur, operations management.
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