arXiv AI By Madeleine Pollack, Thomas Daillak, Mehmet Toner, Korkut Uygun, Heidi Yeh, Swati Gupta

When Should AI Decide, Defer, and Deviate? Responsible Automation for Deceased Donor Kidney Allocation

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The paper proposes an AI framework called the Arbitrator to decide when to recommend, defer, or deviate from historical decisions in deceased-donor kidney allocation. Using data from 2016‑2019 and 2023‑2025, the Arbitrator resolves 93.5% of placement decisions with interpretable medical criteria and defers the remaining 6.5% to humans or more complex models. It identifies 70.1% of historically discarded low‑KDPI kidneys as suitable for out‑of‑sequence allocation, suggesting that up to 43.9% of discarded kidneys could be expedited for transplant.

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