Complexities of Increasing Organ Supply

This chapter investigates why the various matching and swapping arrangements are hard to implement, arguing it is difficult to schedule even one transplant in ways that are convenient for the donor and meet the needs of the recipient. The chapter analyses the difficulties of this complicated exchange, especially if there are two or more transplants. With such awareness, the chapter reviews the innovative program that was recently initiated at the University of California, Los Angeles Medical Center, which allows people to donate a kidney today in exchange for a voucher that a designated recipient can redeem for a kidney in the future if and when a kidney is needed. Even though the new and more complex elaboration of paired exchanges or vouchers increased the pool of people who can donate and increased the chances for people on transplant waiting lists to get an organ, the chapter explores how they begin to look more and more like markets. And, in most countries, markets in organs are illegal.