This proposal seeks to improve how the OPTN Kidney Paired Donation Pilot Program (OPTN KPD) prioritizes candidate-donor matches identified in KPD exchanges (2-way, 3-way, and chains) to increase the likelihood of finding matches for difficult-to-match candidates. UNOS performs a match run on a regular basis to identify all possible exchanges. The match run often identifies more than one possible exchange for the same candidate-donor pair. Since each donor can only donate once, the OPTN KPD uses an optimization algorithm to select a single set of exchanges in which no pair is included more than once. The optimization algorithm searches for the combination of exchanges that maximizes the total number of “priority points” according to current OPTN KPD policy.

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