Modern exchanges include 2-and 3-way swaps, making the kidney exchange clearing problem NPhard.

Our methods rely on an "oracle" to solve the NP-hard kidney exchange matching problem.

Modern exchanges include 2-and 3-way swaps, making the kidney exchange clearing problem NPhard.

Our methods rely on an "oracle" to solve the NP-hard kidney exchange matching problem.

The kidney paired donation (KPD) program provides an innovative solution to overcome incompatibility challenges in kidney transplants by matching incompatible donor-patient pairs and facilitating kidney exchanges. To address unequal access to transplant opportunities, there are two widely used fairness criteria: group fairness and individual fairness. However, these criteria do not consider protected patient features, which refer to characteristics legally or ethically recognized as needing protection from discrimination, such as race and gender. Motivated by the calibration principle in machine learning, we introduce a new fairness criterion: the matching outcome should be conditionally independent of the protected feature, given the sensitization level. We integrate this fairness criterion as a constraint within the KPD optimization framework and propose a computationally efficient solution. Theoretically, we analyze the associated price of fairness using random graph models. Empirically, we compare our fairness criterion with group fairness and individual fairness through both simulations and a real-data example.

While people generally trust AI to make decisions in various aspects of their lives, concerns arise when AI is involved in decisions with significant moral implications. The absence of a precise mathematical framework for moral reasoning intensifies these concerns, as ethics often defies simplistic mathematical models. Unlike fields such as logical reasoning, reasoning under uncertainty, and strategic decision-making, which have well-defined mathematical frameworks, moral reasoning lacks a broadly accepted framework. This absence raises questions about the confidence we can place in AI's moral decision-making capabilities. The environments in which AI systems are typically trained today seem insufficiently rich for such a system to learn ethics from scratch, and even if we had an appropriate environment, it is unclear how we might bring about such learning. An alternative approach involves AI learning from human moral decisions. This learning process can involve aggregating curated human judgments or demonstrations in specific domains, or leveraging a foundation model fed with a wide range of data. Still, concerns persist, given the imperfections in human moral decision making. Given this, why should we ever automate moral decision making -- is it not better to leave all moral decision making to humans? This paper lays out a number of reasons why we should expect AI systems to engage in decisions with a moral component, with brief discussions of the associated risks.

Tuomas Sandholm is the winner of the 2023 AAAI Award for Artificial Intelligence for the Benefit of Humanity. This award recognizes positive impacts of artificial intelligence to protect, enhance, and improve human life in meaningful ways. Tuomas delivered an invited talk at the AAAI Conference on Artificial Intelligence, during which he spoke about the work that won him the award – using algorithms for organ exchanges. Kidney disease is becoming more prevalent in the world, and, in the USA alone, over 90,000 people are waiting for a kidney transplant. This waiting list keeps growing year on year.

In barter exchanges, participants swap goods with one another without exchanging money; exchanges are often facilitated by a central clearinghouse, with the goal of maximizing the aggregate quality (or number) of swaps. Barter exchanges are subject to many forms of uncertainty--in participant preferences, the feasibility and quality of various swaps, and so on. Our work is motivated by kidney exchange, a real-world barter market in which patients in need of a kidney transplant swap their willing living donors, in order to find a better match. Modern exchanges include 2- and 3-way swaps, making the kidney exchange clearing problem NP-hard. Planned transplants often fail for a variety of reasons--if the donor organ is refused by the recipient's medical team, or if the donor and recipient are found to be medically incompatible. Due to 2- and 3-way swaps, failed transplants can "cascade" through an exchange; one US-based exchange estimated that about 85% of planned transplants failed in 2019. Many optimization-based approaches have been designed to avoid these failures; however most exchanges cannot implement these methods due to legal and policy constraints. Instead we consider a setting where exchanges can query the preferences of certain donors and recipients--asking whether they would accept a particular transplant. We characterize this as a two-stage decision problem, in which the exchange program (a) queries a small number of transplants before committing to a matching, and (b) constructs a matching according to fixed policy. We show that selecting these edges is a challenging combinatorial problem, which is non-monotonic and non-submodular, in addition to being NP-hard. We propose both a greedy heuristic and a Monte Carlo tree search, which outperforms previous approaches, using experiments on both synthetic data and real kidney exchange data from the United Network for Organ Sharing.

Motivated by kidney exchange, we study a stochastic cycle and chain packing problem, where we aim to identify structures in a directed graph to maximize the expectation of matched edge weights. All edges are subject to failure, and the failures can have nonidentical probabilities. To the best of our knowledge, the state-of-the-art approaches are only tractable when failure probabilities are identical. We formulate a relevant non-convex optimization problem and propose a tractable mixed-integer linear programming reformulation to solve it. In addition, we propose a model that integrates both risks and the expected utilities of the matching by incorporating conditional value at risk (CVaR) into the objective function, providing a robust formulation for this problem. Subsequently, we propose a sample-average-approximation (SAA) based approach to solve this problem. We test our approaches on data from the United Network for Organ Sharing (UNOS) and compare against state-of-the-art approaches. Our model provides better performance with the same running time as a leading deterministic approach (PICEF). Our CVaR extensions with an SAA-based method improves the $\alpha \times 100\%$ ($0<\alpha\leqslant 1$) worst-case performance substantially compared to existing models.

AI algorithms increasingly make decisions that impact entire groups of humans. Since humans tend to hold varying and even conflicting preferences, AI algorithms responsible for making decisions on behalf of such groups encounter the problem of preference aggregation: combining inconsistent and sometimes contradictory individual preferences into a representative aggregate. In this paper, we address this problem in a real-world public health context: kidney exchange. The algorithms that allocate kidneys from living donors to patients needing transplants in kidney exchange matching markets should prioritize patients in a way that aligns with the values of the community they serve, but allocation preferences vary widely across individuals. In this paper, we propose, implement and evaluate a methodology for prioritizing patients based on such heterogeneous moral preferences. Instead of selecting a single static set of patient weights, we learn a distribution over preference functions based on human subject responses to allocation dilemmas, then sample from this distribution to dynamically determine patient weights during matching. We find that this methodology increases the average rank of matched patients in the sampled preference ordering, indicating better satisfaction of group preferences. We hope that this work will suggest a roadmap for future automated moral decision making on behalf of heterogeneous groups.