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Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?

In United States (U.S.), government-funded organizations, such as NLDAC, reimburse travel and subsistence expenses incurred during living-organ donation process. However, in Iran, there is a non-governmental organization called Iranian Kidney Foundation (IKF) that funds the direct and indirect costs...

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Autores principales: Hosseinzadeh, Arian, Najafi, Mehdi, Cheungpasitporn, Wisit, Thongprayoon, Charat, Fathi, Mahdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709455/
https://www.ncbi.nlm.nih.gov/pubmed/34945855
http://dx.doi.org/10.3390/jpm11121383
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author Hosseinzadeh, Arian
Najafi, Mehdi
Cheungpasitporn, Wisit
Thongprayoon, Charat
Fathi, Mahdi
author_facet Hosseinzadeh, Arian
Najafi, Mehdi
Cheungpasitporn, Wisit
Thongprayoon, Charat
Fathi, Mahdi
author_sort Hosseinzadeh, Arian
collection PubMed
description In United States (U.S.), government-funded organizations, such as NLDAC, reimburse travel and subsistence expenses incurred during living-organ donation process. However, in Iran, there is a non-governmental organization called Iranian Kidney Foundation (IKF) that funds the direct and indirect costs of donors through charitable donations and contributions from participants in the exchange program. In this article, for countries outside the U.S. that currently use an equality approach, we propose a potential new compensation-apportionment approach (equitable approach) for kidney-exchange chains and compare it with the currently available system (equality approach) in terms of the apportionment of compensation in a kidney-exchange chain to cover the expenses incurred by the initiating living donor of the chain in the act of donation. To this end, we propose a mechanism to apportion compensation among all participating pairs based on the equity approach by utilizing a prediction model to calculate the probability of graft survival in each transplant operation. These probabilities are then used to define the utility of any transplantation, considering the quality of each pair’s donated and received kidney in the chain. Afterward, the corresponding cost is apportioned by a mechanism based on the normalized differences between the utility of donated and received kidneys for each incompatible pair of the chain. In summary, we demonstrate that by utilizing the equitable approach, there is more fairness and equity in the allocation of resources in organ-procurement systems, which results in more satisfaction among incompatible pairs. Additional future prospective studies are needed to assess this proposed equitable approach for kidney-exchange chains in countries outside the U.S., such as Iran, that currently use an equality approach.
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spelling pubmed-87094552021-12-25 Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain? Hosseinzadeh, Arian Najafi, Mehdi Cheungpasitporn, Wisit Thongprayoon, Charat Fathi, Mahdi J Pers Med Review In United States (U.S.), government-funded organizations, such as NLDAC, reimburse travel and subsistence expenses incurred during living-organ donation process. However, in Iran, there is a non-governmental organization called Iranian Kidney Foundation (IKF) that funds the direct and indirect costs of donors through charitable donations and contributions from participants in the exchange program. In this article, for countries outside the U.S. that currently use an equality approach, we propose a potential new compensation-apportionment approach (equitable approach) for kidney-exchange chains and compare it with the currently available system (equality approach) in terms of the apportionment of compensation in a kidney-exchange chain to cover the expenses incurred by the initiating living donor of the chain in the act of donation. To this end, we propose a mechanism to apportion compensation among all participating pairs based on the equity approach by utilizing a prediction model to calculate the probability of graft survival in each transplant operation. These probabilities are then used to define the utility of any transplantation, considering the quality of each pair’s donated and received kidney in the chain. Afterward, the corresponding cost is apportioned by a mechanism based on the normalized differences between the utility of donated and received kidneys for each incompatible pair of the chain. In summary, we demonstrate that by utilizing the equitable approach, there is more fairness and equity in the allocation of resources in organ-procurement systems, which results in more satisfaction among incompatible pairs. Additional future prospective studies are needed to assess this proposed equitable approach for kidney-exchange chains in countries outside the U.S., such as Iran, that currently use an equality approach. MDPI 2021-12-18 /pmc/articles/PMC8709455/ /pubmed/34945855 http://dx.doi.org/10.3390/jpm11121383 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Hosseinzadeh, Arian
Najafi, Mehdi
Cheungpasitporn, Wisit
Thongprayoon, Charat
Fathi, Mahdi
Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title_full Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title_fullStr Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title_full_unstemmed Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title_short Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?
title_sort equity or equality? which approach brings more satisfaction in a kidney-exchange chain?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709455/
https://www.ncbi.nlm.nih.gov/pubmed/34945855
http://dx.doi.org/10.3390/jpm11121383
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