NEAD Chains in Transplantation

Gentry and Segev (1) speculate above that the results reported in Ashlagi et al. (2), that nonsimultaneous extended altruistic donor (NEAD) chains produce more transplants than domino-paired donation (DPD), would be reversed if the computation were conducted for more periods. Here, we carry out the computation and show that, contrary to their conjecture, nonsimultaneous chains continue to allow more transplants than simultaneous chains, even over a longer time horizon. Furthermore, more highly sensitized patients are transplanted by allowing chains to continue with bridge donors rather than automatically ending with donations to patients on the deceased donor waiting list.