Carlo simulation size of 100 trials for three different population sizes of 30, 100, and 300 pairs. KIDNEY EXCHANGE 477 IV.D. Discussion of Results The simulation results suggest that substantial gains in the number and match quality of transplanted kidneys might result from adoption of the TTCC mechanism. We report the details of this analysis in three tables. The rows of the tables refer to different regimes, under different preference constructions, and different population sizes. Table III reports the general patient statistics under each regime. The first column reports the total live donor transplants as percentage of the population size, which is the sum of the next two columns, transplants from own compatible donor and transplants from trades. The fourth column is the percentage of patients upgraded to the top of the wait-list through indirect exchanges. The fifth column reports the quality of matches in the live donor transplants: the lower the HLA mismatch is, the higher the odds of graft survival. Standard errors are reported below the estimates. In Table IV we report the effect of each regime on the waitlist additions for each blood type. The columns are separated into two main groups. The first group reports the net percentage of patients sent to the top of the wait-list due to indirect exchanges (the percentages are taken with respect to all paired patients). This is a net upgrade burden, i.e., the difference between the patients added at the top of the list and the living-donor kidneys made available for the wait-list patients. The second group reports (again as a percentage of all paired patients) the rate of paired patients who nonetheless are sent to the cadaveric waiting list because the patient is not assigned a living-donor kidney. In Table V, we report the sizes of cycles and w-chains under each mechanism. The columns are divided into two groups for cycles and w-chains. Each group reports the number, the average length, the average maximum (per group, over all 100 trials) lOrgan transplantation is a highly effective treatment for advanced organ failure that relies on the donation of organs from living or deceased persons. The focus of this document is on the transplantation of solid organs donated from deceased persons. Currently, the number of patients who might potentially benefit from transplantation is far greater than the number of organs donated. For this reason, organ transplantation is offered primarily to patients who have end-stage organ disease and—with the exception of kidney transplantation—who have exhausted all alternative treatment options. Furthermore, transplantation is offered only to patients who have a reasonable prospect of achieving an acceptably good quality and duration of life after transplantation. Decision-making regarding the allocation and transplantation of donated organs seeks to balance the needs of individual patients against the need to maximise the overall benefit to the community from this scarce and valuable resource. The Transplantation Society of Australia and New Zealand (TSANZ) is the body responsible for developing eligibility criteria for organ transplantation and protocols for the allocation of deceased donor organs to wait-listed patients. Specifically, TSANZ is funded by the Australian Government’s Organ and Tissue Authority to maintain: 1. Current, nationally uniform eligibility criteria to ensure that there are equitable and transparent criteria by which patients are listed for organ transplantation, and 2. Current, nationally uniform allocation protocols to ensure consistency in the criteria by which donated organs are allocated. The TSANZ document Organ Transplantation from Deceased Donors: Consensus Statement on Eligibility Criteria and Allocation Protocols was released in version 1.1 in June 2011, version 1.2 in May 2012, and version 1.3 in January 2014; version 1.4 was released in April 2015. The current document (Clinical Guidelines for Organ Transplantation from Deceased Donors) replaces the previous Consensus Statement, and was developed by the TSANZ Advisory Committees with written feedback sought through a targeted consultation process (see Appendix B). Version 1.0 of the Clinical Guidelines was released in April 2016, with updates released in May 2017 (version 1.1), and December 2018 (version 1.2). The current document, Version 1.3, updates and replaces all prior versions of the Clinical Guidelines. Central to the eligibility criteria and allocation protocols described in this document are the following ethical principles, which are embodied in the National Health and Medical Research Council (NHMRC) publication Ethical Guidelines for Organ Transplantation from Deceased Donors (the Ethical Guidelines):1 1. Decision-making regarding allocation must involve explicit evaluation of the risk and benefits to the potential recipient as well as the need to ensure the appropriate use of scarce health resources. 2. There must be no unlawful or unreasonable discrimination against potential recipients on the basis of: • Race, religious belief, gender, marital status, sexual orientation, social or other status, disability or age • The need for a transplant arising from the medical consequences of past lifestyle • Capacity to pay for treatment • Location of residence (e.g. remote, rural, regional or metropolitan) • Previous refusal of an offer of an organ for transplantation •