Finding long chains in kidney exchange using the traveling salesman problem

Abstract

There are currently more than 100,000 patients on the waiting list in the United States for a kidney transplant from a deceased donor. To address this shortage, kidney exchange programs allow patients with living incompatible donors to exchange donors through cycles and chains initiated by altruistic nondirected donors. To determine which exchanges will take place, kidney exchange programs use algorithms for maximizing the number of transplants under constraints about the size of feasible exchanges. This problem is NP-hard, and algorithms previously used were unable to optimize when chains could be long. We developed two algorithms that use integer programming to solve this problem, one of which is inspired by the traveling salesman, that together can find optimal solutions in practice.