Optimal production of transplant care services.

Most organ transplants are from dead donors. National transplant organizations exhibit considerable differences in terms of their donor population rates. Spain’s organization is by far the most efficient in this respect. We argue that much of the productivity advantage of Spain’s transplant organization proceeds from an efficient organization of the production chain, from organ procurement to transplantation. Transplant inputs from dead donors are analogous to a common resource for the transplant community. Their circulation through the national transplant organization creates public good externalities between the care units in charge of organ extraction and those in charge of transplantation. It is shown that a socially efficient production of transplant services requires an optimal control of both the production and the circulation of transplant inputs by the institutions of the transplant system.