Does Transportation Mean Transplantation? Impact of New Airline Routes on Sharing of Cadaveric Kidneys

Management Science, Forthcoming

46 Pages Posted: 6 May 2020 Last revised: 24 Mar 2021

See all articles by Guihua Wang

Guihua Wang

University of Texas at Dallas - Naveen Jindal School of Management

Ronghuo Zheng

The University of Texas at Austin - McCombs School of Business

Tinglong Dai

Johns Hopkins University - Carey Business School

Date Written: March 20, 2021

Abstract

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 co-existence 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, due to 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 datasets, 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 post-transplant survival rate remains largely unchanged, though 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.

Keywords: Organ transplantation, airline transportation, pooling, flexibility, causal inference

JEL Classification: I11, R41, D24

Suggested Citation

Wang, Guihua and Zheng, Ronghuo and Dai, Tinglong, Does Transportation Mean Transplantation? Impact of New Airline Routes on Sharing of Cadaveric Kidneys (March 20, 2021). Management Science, Forthcoming, Available at SSRN: https://ssrn.com/abstract=3582675 or http://dx.doi.org/10.2139/ssrn.3582675

Guihua Wang

University of Texas at Dallas - Naveen Jindal School of Management ( email )

P.O. Box 830688
Richardson, TX 75083-0688
United States

Ronghuo Zheng

The University of Texas at Austin - McCombs School of Business ( email )

Austin, TX 78712
United States

Tinglong Dai (Contact Author)

Johns Hopkins University - Carey Business School ( email )

100 International Drive
Baltimore, MD 21202
United States

HOME PAGE: http://carey.jhu.edu/faculty/tinglong-dai-phd

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