Hungarian researchers develop domestic and international kidney exchange programs


As part of the COST Action program, staff at the Mechanism Design Momentum Research Group at the Institute of Economics of ELKH KRTK are participating in the study and planning of kidney exchange programs in Europe and in the development of simulation software. Dr. Péter Biró, leader of the international project's primary work group, organized the mapping of the European applications and the examination of the program's optimization criteria. Summary publications have recently appeared in the journals Transplantation and EJOR.

A transplant is the only medical solution capable of providing a long-term solution to end-stage renal disease, but a growing shortage of deceased donors has brought living donor transplantation to the fore in developed countries. Kidney patients who have a volunteer living donor but are immunologically incompatible with them can now exchange donors with each other through well-organized kidney exchange programs to ensure that eventually everyone is able to find a compatible donor. Kidney exchanges are performed either in short, simultaneous rounds of exchange or in longer donation chains initiated by voluntary donors in advanced programs worldwide.


In Europe, national kidney exchange programs are found in at least ten countries, while international collaborations have begun in three European regions. The largest program is in the UK, where the program has enabled more than 1,000 patients to receive transplants since 2007. Péter Biró was also involved in the development of that program's pairing algorithm from 2007 to 2010 as a postdoctoral researcher at the University of Glasgow[1]. The area's scientific field is truly interdisciplinary. In addition to doctors, computer technicians, mathematicians and economists are also involved in the study and design of the applications. Alvin Roth's work in this area was also given a prominent role in the justification for his 2012 Nobel Prize in Economics.

Professor Roth invited Péter Biró to spend a research year at Stanford in 2014, before he established the Mechanism Design research group within the framework of the MTA's Momentum program in 2016 [2]. The group primarily conducts research in the field of preferential pairing applications. In addition to kidney exchange programs, these applications can be used in the field of university admissions, for example. In addition to the Momentum project, the Excellence Cooperation Program of the Hungarian Academy of Sciences and NKFIH also provided support for their research. From 2016, they will also participate in the COST Action work of the European Network for Collaboration on Kidney Exchange Programs [3].

ENCKEP COST Action has set up an interdisciplinary research network to map and scientifically study European applications. As a first step, details of all programs in Europe were explored in a survey [4]. As a second step, the models and solution methods used for optimization were examined [5]. The team is currently working on the development of a computer simulator involving domestic researchers and students to test the long-term effectiveness of national and international programs on both real and generated data, using various optimization settings and policies of collaboration.

The Hungarian kidney exchange program was discussed by transplant experts at the Congress of the Hungarian Transplantation Society held in Debrecen in the autumn of 2018, as well as at the related ENCKEP workshop, and a consensus proposal was developed as a result[6]. OVSZ has begin to implement the proposal, but unfortunately, due to the pandemic situation, the first pairing has not yet taken place. Ágnes Cseh, a mathematician in the Mechanism Design Research Group, is currently participating in the development of a kidney exchange program in Germany through a non-profit initiative[7]. Germany is the only major European country that does not yet have such a program, mainly due to regulatory barriers.


  1. Biró, D.F. Manlove and R. Rizzi. Maximum weight cycle packing in directed graphs, with application to kidney exchange programs. Discrete Mathematics, Algorithms and Applications 1(4), pp:499-517, 2009.
  2. Mechanizmustervezés Lendület kutatócsoport honlapja
  3. ENCKEP (European Network for Collaboration on Kidney Exchange Programmes) COST Action honlapja
  4. Biró, Bernadette Haase, and et al.: Building kidney exchange programmes in Europe – an overview of exchange practice and activities. Transplantation, 103 (7): 1514-1522, 2019.
  5. Biró, J. van de Klundert, D. Manlove, and et al.: Modelling and optimisation in European Kidney Exchange Programmes. European Journal of Operational Research, 2020.
  6. Biró P, Remport Á, Mihály S, Illésy L, Nemes B. Élődonoros vesecsereprogramok Európában. Hol tart Magyarország? Összefoglaló tanulmány az ENCKEP (European Network for Collaboration on Kidney Exchange Programmes) COST Action eddigi eredményei alapján. Orvosi Hetilap. 2018;159(46):1905-1912.
  7. Susanne Reitmaier honlapja, német civil kezdeményezés vesecsere-program létrehozására