Abstract

Kidney exchange is often analyzed under dichotomous preferences, where any medically
compatible kidney is treated as equally desirable. This thesis studies the role of dichotomous
preferences in two-way kidney exchanges. Under these assumptions, maximizing the total number
of transplants is the same as achieving Pareto-efficiency. Furthermore, we can use priority
rules (Roth et al., 2005) to choose recipients with a maximum total number of transplants. The
thesis investigates how these findings change once quality heterogeneity is introduced through
strict preferences. Using constructive examples, the analysis demonstrates that, under strict cardinal
preferences, maximizing total weight can reduce transplant volume and create incentives for
agents to misreport acceptability. The thesis is organized as follows: the first part provides a structured
review of the relevant kidney-exchange and mechanism-design literature, and the second part
develops a comparative analysis clarifying which properties persist and which fail as preferences
move beyond dichotomous preferences toward a cardinal framework.