1. ORGAN TRANSPLANTATION Ben Durham, Kathryn Goodridge, Pujan Patel, Chelsea Perry, and Sagar Shah

2. Approximately 18 patients die each day in the U.S. as a direct result of the shortage of kidneys available for transplantation.

3. Overview ➢ Incentives for Producers and Consumers ➢ Characteristics of Consumers ➢ Inputs ➢ The Role of the Government ➢ An Entrepreneurial Solution

4. Key Terms ➢ Output: Kidney Transplant Surgery ➢ Inputs: “Transplantable Kidney” and Capital/Labor Inputs ➢ Suppliers: Medical Facilities and the Donor ➢ Producer: Providers and the Donor ➢ Consumer: Patients

5. Biological Producer Economic Producer Supplier Output Supplier: Registered donor supplying/ donating the kidney Output: Kidney Transplant Surgery Economic Producers: Registered donor with transplantable kidney Biological Producer: Humans with kidneys

6. Producers & Consumers ➢ Consumers -Patients on kidney transplant waiting list ➢ Producers -Kidney Donors -Healthcare Providers

7. Consumer Incentives & Behaviors ➢ Incentives -Need for survival -Increase quality of life ➢ Behaviors -Meet kidney eligibility requirements -Obtain coverage

8. Producer 1: Kidney Donor ➢ Incentives -Goodwill -Personal Relationships -Lasting Legacy ➢ Behaviors -Donate a Kidney -Organ Donor Registration

9. Producer 2: Healthcare Provider ➢ Incentives -Goodwill -Clinical Interest -Financial Returns ➢ Behaviors -Promote and Perform the Kidney Transplantation

10. Traditional Market ➢ Producer makes product for generic consumer ➢ For Example: -A Pen company produces pens for a generic customer

11. Market for Kidney Transplants ➢ Much more specific -Genotypic Matching -Immune system compatibility -Genetic factors -Blood Type

12. If Kidney and Recipient Mismatch ➢ Acute Organ Rejection ➢ Morbidity ➢ Death

13. Third Party Influence ➢ UNOS determines kidney allocation by using metrics such as: -Life-Years from Transplant -Dialysis Time -Donor Profile Index

14. Substitute ➢ Hemodialysis Pro- Prolong the need for a Kidney Transplant Con- Inconvenient, Associated with Morbidity

15. Two Main Inputs ➢ Transplantable Kidney ➢ Medical Facilities with Capital and Labor Inputs

16. Characteristics of the Medical Facility ➢ Labor Inputs -Skilled Staff -Pre and Post Surgical Care -Organ Transportation System ➢ Capital Inputs -Supportive Resources for the completion of transplant -Specialized Equipment

17. Effects of Incentives on the Suppliers ➢ Medical Facilities -Few Financial benefits -Need to meet their community health assessments -No Shortages of medical facilities ➢ Donors -Lack of incentives to become a donor -Shortages in transplantable kidneys

18. Gap Between Supply and Demand

19. The Government’s Role in the Market ➢ Complicated, Controversial, and Highly Regulated ➢ Excess Demand for Kidney is Critical Policy Issue ➢ Strict Legal Limit on Market for Organs

20. The Government’s Role in the Market ➢ National Organ Transplantation Act of 1986 (NOTA) -Prohibits Market for Organs ➢ Legal Procurement a function of United Network for Organ Sharing (UNOS) ➢ Regional Organ Procurement Organizations (OPOs)

21. Government Behavior’s Effect on Market ➢ Implications for Supply ➢ Uniform Anatomical Gift Act = Consent ➢ Organ donation registration via “opting-in”

22. Government Behavior’s Effect on Market ➢ Policies augment organ shortage ➢ Generates Black Market ➢ Time cost ➢ Imperfect information -Government’s behavior does not necessarily reinforce imperfect information, but it does not alleviate it

23. Entrepreneurial Solution ➢ Shortage ➢ 3 Ways to Increase Supply -Wearable Artificial Kidney (WAKS) -Grow in a Lab -3D Printing

24. Which One? ➢ WAKS are feasible, but other options preferable ➢ Growing in a lab slow, high labor costs ➢ 3D printing market is huge, and the process is much faster, might have higher capital costs, but lower labor costs

25. What to Produce? ➢ Whole kidney is not necessary, but a “mini-kidney” will restore function above the level that requires hemodialysis ➢ Our friend can then expand into other areas of the 3D organ printing market and help with shortages there

26. Summary ➢ Incentives for Producers and Consumers ➢ Characteristics of Consumers ➢ Inputs ➢ The Role of the Government ➢ An Entrepreneurial Solution

27. Take-Away ➢ Shortage in Organ Markets ➢ Lack of Incentives -Exacerbated by clinical criteria and government regulation ➢ The Future...

28. Questions & Answers