Nikhil Agarwal, Itai Ashlagi, Eduardo Azevedo, Clayton Featherstone, Omer Karaduman, 03 November 2018

National kidney exchange platforms significantly boost the number of life-saving kidney transplants by finding complicated exchange arrangements that are not possible within any single hospital. This column examines US data and finds that the majority of kidney exchanges continue to be performed within hospitals, suggesting a fragmented market that comes at a large efficiency cost. National platforms may need to be redesigned to encourage full participation, with reimbursement reform.

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