Showing posts with label algorithms. Show all posts
Showing posts with label algorithms. Show all posts

Sunday, October 13, 2024

Stable matching in Scientific American

 Here's a short article in Scientific American, describing the deferred acceptance algorithm and mentioning some uses for stable matching. (When I was a child, Scientific American opened a window on science for me...)

The ‘Stable Marriage Problem’ Solution Underpins Dating Apps and School Admissions. An elegant matchmaking algorithm called Gale-Shapley can find the best possible pairings for everybody.   By Max Springer

"Let’s create a reality dating show unlike any other in one key aspect. First, we’ll rent a villa on a tropical island. Then we’ll fly in five men and five women, each with their own (heterosexual) dating preferences. Our goal, though, is the exact opposite of the Love Island franchise: we want absolutely zero drama. Can we ensure that everyone pairs off with a partner and sticks with them, without jealousy rearing its ugly head?" 

########

Along the way they briefly quote these luminaries (in the order in which they appear): 

Vijay Vazirani, Jon Kleinberg, Utku Ünver, and Éva Tardos.

Sunday, September 29, 2024

Gaming a bike sharing algorithm

 Jacob Leshno points out this NYT story. He writes "The gist of it is that Citi bike pays to deliver bikes to stations with shortages, and someone figured they could make money by creating artificial shortages."

The Hustlers Who Make $6,000 a Month by Gaming Citi Bikes. The bike-sharing program rewards users who help redistribute bikes around New York City. A few riders have figured out how to turn that into profit.  By Christopher Maag (Christopher Maag spent several days in Midtown Manhattan running behind Bike Angels.)

"By monitoring a map of stations on Lyft’s app, they noticed that the algorithm awards points on a sliding scale based on need. Removing a bike from a completely full station: up to four points. Docking at an empty station? That’s worth up to another four. People who move at least four bikes in a 24-hour period get all their points multiplied by a factor of three.

"Lyft pays 20 cents per point. Each ride generates a maximum of 24 points. In perfect conditions, a person on a 3X streak who relocates a bike from a full dock to a completely empty one can earn as much as $4.80 for a single ride.

...

"At 10 a.m. on a Tuesday last month, seven Bike Angels descended on the docking station at Broadway and 53rd Street, across from the Ed Sullivan Theater. Each rider used his own special blue key — a reward from Citi Bike — to unlock a bike. He rode it one block east, to Seventh Avenue. He docked, ran back to Broadway, unlocked another bike and made the trip again.

"By 10:14, the crew had created an algorithmically perfect situation: One station 100 percent full, a short block from another station 100 percent empty. The timing was crucial, because every 15 minutes, Lyft’s algorithm resets, assigning new point values to every bike move.

"The clock struck 10:15. The algorithm, mistaking this manufactured setup for a true emergency, offered the maximum incentive: $4.80 for every bike returned to the Ed Sullivan Theater. The men switched direction, running east and pedaling west."


Friday, August 30, 2024

Automated bidding in auctions

 Part of the future of market design (as artificial intelligence evolves from large language models to something more like general AI) will involve not only the design of marketplace rules, but also design of the marketplace participants.  So a good way to get some sense of that future is to look at parts of it that have already arrived.  And there are lots of algorithms already at work participating in high frequency markets.  Here's a paper surveying automated bidding on ad auctions, by a big group of authors at Google.

Auto-bidding and Auctions in Online Advertising: A Survey by Gagan Aggarwal, Ashwinkumar Badanidiyuru, Santiago R. Balseiro, Kshipra Bhawalkar, Yuan Deng, Zhe Feng, Gagan Goel, Christopher Liaw, Haihao Lu, Mohammad Mahdian, Jieming Mao, Aranyak Mehta, Vahab Mirrokni, Renato Paes Leme, Andres Perlroth, Georgios Piliouras, Jon Schneider, Ariel Schvartzman, Balasubramanian Sivan, Kelly Spendlove, Yifeng Teng, Di Wang, Hanrui Zhang, Mingfei Zhao, Wennan Zhu, and Song Zuo

Abstract: In this survey, we summarize recent developments in research fueled by the growing adoption of automated bidding strategies in online advertising. We explore the challenges and opportunities that have arisen as markets embrace this autobidding and cover a range of topics in this area, including bidding algorithms, equilibrium analysis and efficiency of common auction formats, and optimal auction design



Thursday, April 25, 2024

The Matching Society by Melchior Simioni and Philippe Steiner

"If we put on the glasses of economic sociology, it appears ... that matching corresponds to a specific form of coordination close but distinct from both planning and the market."

That's a sentence that caught my eye (using Google translate) from the recent book by the French sociologists Melchior Simioni and Philippe Steiner

La société du matching (The Matching Society) 


Here's how the publisher's web page introduces it:

"The upheavals brought about by the irruption of matching technology, in all its dimensions, are updating major challenges in our societies. The matching society is not the future of our modern societies, it is its present. The ambition of this essay is to to understand what it changes in our lives.  

"At several decisive stages of our lives, we entrust our fate to algorithms that sort individuals according to a very singular pattern: we choose and we are chosen at the same time. Access to resources as essential as training (with Parcoursup or Affelnet), a romantic partner (Tinder, Meetic and so many others), certain care or a job depends on this technology.

"Unlike the market relationship, where paying is enough, or social benefits, which are paid as a matter of right, matching presupposes a new social relationship: we express our wishes according to the information at our disposal and it is on the basis of the data we provide that the selection is made.

"This principle profoundly changes our relationship with the collective. Because it forces us to tell the truth about ourselves, our hopes, our desires, it accelerates the advent of a singularist society."

########

I've had occasion to blog about the work of Professor Steiner before:

Friday, August 12, 2022

Monday, November 30, 2020

Thursday, April 18, 2024

Top Trading Cycles (TTC) and the 50th anniversary of the Journal of Mathematical Economics

 This year marks the 50th anniversary of the Journal of Mathematical Economics, and also of the Top Trading Cycles (TTC) algorithm that was introduced in Volume 1, number 1 of the journal, in the paper by

Shapley, Lloyd, and Herbert Scarf. "On cores and indivisibility." Journal of mathematical economics 1, no. 1 (1974): 23-37. 

TTC was further analyzed in 

Roth, Alvin E., and Andrew Postlewaite. "Weak versus strong domination in a market with indivisible goods." Journal of Mathematical Economics 4, no. 2 (1977): 131-137.

Now the JME is assembling a 50th anniversary collection of papers surveying some of the resulting literatures, with some papers posted online ahead of publication. Here's what they had as of yesterday, including an article on Top Trading Cycles, by Morrill and Roth, and one on Housing markets since Shapley and Scarf, by Afacan, Hu, and Li:

JME’s 50th Anniversary Literature  Edited by Andres Carvajal and Felix Kübler

  1. Top trading cycles

    In Press, Journal Pre-proof, Available online 16 April 2024
    Article 102984
    View PDF
  2. Bubble economics

    April 2024
    Article 102944
    View PDF
  3. Stable outcomes in simple cooperative games

    April 2024
    Article 102960
    View PDF
  4. Fifty years of mathematical growth theory: Classical topics and new trends

    April 2024
    Article 102966
    View PDF
  5. Housing markets since Shapley and Scarf

    April 2024
    Article 102967
    View PDF

##########

At least one of the papers in the (virtual) special issue is already published, I gather that some will be in the June issue:

Monday, March 4, 2024

Monday, December 18, 2023

Algorithmic Mechanism Design With Investment, by Akbarpour, Kominers, Li, Li, and Milgrom,

 Mechanisms that are computationally complex may require approximation in implementation, which can change the incentive properties of the exact mechanism.   But progress can be made...

Algorithmic Mechanism Design With Investment, by Mohammad Akbarpour, Scott Duke Kominers, Kevin Michael Li, Shengwu Li, Paul Milgrom, Econometrica, First published: 07 December 2023, https://doi.org/10.3982/ECTA19559

Abstract: We study the investment incentives created by truthful mechanisms that allocate resources using approximation algorithms. Some approximation algorithms guarantee nearly 100% of the optimal welfare in the allocation problem but guarantee nothing when accounting for investment incentives. An algorithm's allocative and investment guarantees coincide if and only if its confirming negative externalities are sufficiently small. We introduce fast approximation algorithms for the knapsack problem that have no confirming negative externalities and guarantees close to 100% for both allocation and investment.

From the introduction:

"Approximation algorithms can be combined with pricing rules to produce truthful mechanisms, provided that the algorithm is “monotone” (Lavi, Mu'Alem, and Nisan (2003)). In this paper, we study the ex ante investment incentives created by such mechanisms.

"Suppose that one bidder can make a costly investment to change its value before participating in a truthful mechanism. As an initial result, we show that all truthful mechanisms using the same allocation algorithm entail the same investment incentives, so we can regard the investment incentives as properties of the algorithm itself.

"If an allocation algorithm exactly maximizes total welfare, then the corresponding truthful mechanism is a Vickrey–Clarke–Groves (VCG) mechanism. For VCG mechanisms, any single bidder's investment is profitable if and only it improves total welfare (Rogerson (1992)). In this respect, the VCG mechanisms are essentially unique. We find that a truthful mechanism aligns a bidder's investment incentives with welfare maximization only if there is some set of allocations such that, for generic valuation profiles, its allocation algorithm exactly maximizes welfare over that set. Many practical approximation algorithms do not have this structure and, as a result, lack efficient investment incentives.

"One might also hope that if an allocation algorithm approximately maximizes total welfare, then it generates approximately efficient investment incentives—but we show to the contrary that arbitrarily good approximations can have arbitrarily bad investment guarantees. To make this statement precise, we evaluate an algorithm's performance on any particular instance by the welfare it achieves divided by the maximum welfare. We refer to the worst-case ratio over all instances when values are exogenous as the allocative guarantee, and the worst-case ratio when one bidder's ex ante investment endogenously determines its value as the investment guarantee.1 (The investment guarantee measures welfare net of investment costs.)

"Because the investment guarantee is a worst case over instances and over investment technologies, it is never more than the allocative guarantee. We characterize the algorithms for which the allocative and investment guarantees are equal, and apply those results to evaluate and improve upon standard approximation algorithms."

Friday, December 1, 2023

Fairness in algorithms: Hans Sigrist Prize to Aaron Roth

 The University of Bern's Hans Sigrist Prize has been awarded to Penn computer scientist Aaron Roth, and will be celebrated today.

Here are today's symposium details and schedule:

Here's an interview:

Aaron Roth: Pioneer of fair algorithms  In December 2023, the most highly endowed prize of the University of Bern will go to the US computer scientist Aaron Roth. His research aims to incorporate social norms into algorithms and to better protect privacy.  by Ivo Schmucki 

"There are researchers who sit down and take on long-standing problems and just solve them, but I am not smart enough to do that," says Aaron Roth. "So, I have to be the other kind of researcher. I try to define a new problem that no one has worked on yet but that might be interesting."

"Aaron Roth's own modesty may stand in the way of understanding the depth of his contributions. In fact, when he authored his doctoral thesis on differential privacy about 15 years ago and then wrote on the fairness of algorithms a few years later, terms like “Artificial Intelligence” and “Machine Learning” were far from being as firmly anchored in our everyday lives as they are today. Aaron Roth was thus a pioneer, laying the foundation for a new branch of research.

"I am interested in real problems. Issues like data protection are becoming increasingly important as more and more data is generated and collected about all of us," says Aaron Roth about his research during the Hans Sigrist Foundation’s traditional interview with the prize winner. He focuses on algorithmic fairness, differential privacy, and their applications in machine learning and data analysis.

...

"It is important that more attention is paid to these topics," says Mathematics Professor Christiane Tretter, chair of this year's Hans Sigrist Prize Committee. Tretter says that many people perceive fairness and algorithms as two completely different poles, situated in different disciplines and incompatible with each other. "It is fascinating that Aaron Roth’s work shows that this is not a contradiction."

...

"The first step to improving the analysis of large data sets is to be aware of the problem: "We need to realize that data analysis can be problematic. Once we agree on this, we can consider how we can solve the problems," says Aaron Roth."





Monday, October 16, 2023

Refugee resettlement and the top trading cycles algorithm, by Farajzadeh, Killea, Teytelboym, and Trapp

 Here's a recent paper that (among other things) considers using the top trading cycles algorithm for matching refugees to sponsors (under a special program for Ukraine), to satisfy the location preferences of refugees.

Optimizing Sponsored Humanitarian Parole by Fatemeh Farajzadeh, Ryan B. Killea, Alexander Teytelboym, Andrew C. Trapp, working paper, 2023

Abstract: The United States has introduced a special humanitarian parole process for Ukrainian citizens in response to Russia’s 2022 invasion of Ukraine. To qualify for parole, Ukrainian applicants must have a sponsor in the United States. In collaboration with HIAS, a refugee resettlement agency involved in the parole process, we deployed RUTH (Refugees Uniting Through HIAS), a novel algorithmic matching system that is driven by the relocation preferences of refugees and the priorities of US sponsors. RUTH adapts Thakral [2016] Multiple-Waitlist Procedure (MWP) that combines the main First-In/First-Out (FIFO) queue with location specific FIFO queues in order to effectively manage the preferences of refugees and the supply of community sponsors. In addition to refugee preferences and sponsor priorities, RUTH incorporates various feasibility considerations such as community capacity, religious, and medical needs. The adapted mechanism is envy-free, efficient and strategy-proof for refugees. Our analysis reveals that refugee preferences over locations are diverse, even controlling for observables, by demonstrating the difficulty of solving a much simpler problem than modeling preferences directly from observables. We use our data for two counterfactual simulations. First, we consider the effects of increased waiting times for refugees on the quality of their matches. We find that with a periodic Top Trading Cycles algorithm, increasing period length from 24 days to 80 days, improves average rank of a refugee’s match from 3.20 to 2.44. On the other hand, using the available preference data RUTH achieved an average rank of 4.07 with a waiting time of 20 days. Second, we estimate the arrival rates of sponsors in each location that would be consistent with a long-run steady state. We find that more desirable locations (in terms of refugee preferences) require the highest arrival rates suggesting that preferences might be a useful indicator for investments in sponsorship capacity. Our study highlights the potential for preference-based algorithms such as RUTH to improve the efficiency and fairness of other rapidly-deployed humanitarian parole processes.

#######

Earlier:

Sunday, December 18, 2022


Wednesday, August 30, 2023

Minimal envy mechanisms, by Julien Combe

 Here's an article I missed when it came out online:

Reallocation with priorities and minimal envy mechanisms, by Julien Combe, Economic Theory volume 76, 551–584 (2023)

"Abstract: We investigate the problem of reallocation with priorities where one has to assign objects or positions to individuals. Agents can have an initial ownership over an object. Each object has a priority ordering over the agents. In this framework, there is no mechanism that is both individually rational (IR) and stable, i.e. has no blocking pairs. Given this impossibility, an alternative approach is to compare mechanisms based on the blocking pairs they generate. A mechanism has minimal envy within a set of mechanisms if there is no other mechanism in the set that always leads to a set of blocking pairs included in the one of the former mechanism. Our main result shows that the modified Deferred Acceptance mechanism (Guillen and Kesten in Int Econ Rev 53(3):1027–1046, 2012), is a minimal envy mechanism in the set of IR and strategy-proof mechanisms. We also show that an extension of the Top Trading Cycle (Karakaya et al. in J Econ Theory 184:104948, 2019) mechanism is a minimal envy mechanism in the set of IR, strategy-proof and Pareto-efficient mechanisms. These two results extend the existing ones in school choice."

Thursday, July 27, 2023

Kidney brouhaha in Israel: is a good deed still good when performed by a shmuck?

 Recently a three way kidney exchange was performed in Israel. This would have been unremarkable under most circumstances: Israel has an active kidney exchange system.  But it caused a strong reaction in the Israeli press, because one of the donors, a  well-known rightwing activist who wanted to donate a kidney so that his brother could receive one, announced that he wanted his kidney to go only to a Jew.

Here's the Ynet story (you can click to render it in English):

 kidney in a transplant marathon: "The condition was - only for a Jew

Here's the Times of Israel (already in English):

Right-wing journalist causes stir by announcing his kidney would go only to a Jew

There were many more, but you get the idea.  Some of the stories point out that the Israeli National Transplantation Center uses an algorithm* that doesn't see the religion of the recipient, so it's not clear that this was a declaration with consequences.  It was meant to provoke, and it did.

But it's a complicated issue.  In the U.S. (and in Israel), donations can be made to a specific individual, but not to a class of individuals.  With living donation, it means that the donor can choose a specific person to donate to, and it isn't an issue how they choose: no one has to donate an organ to anyone, and every donation saves a life (and maybe more than one, particularly since  living donation reduces competition for scarce deceased-donor kidneys). So if this donor had been able to donate to his brother, no one would have thought twice that he was glad to be donating to a fellow Jew.  What made his announcement provocative was that his kidney wasn't going to his brother: his brother was getting a kidney from an anonymous other donor. [Update clarification/correction: this donation was apparently an undirected (except for the 'only' condition) altruistic donation, not part of an exchange involving the donor's brother.]

Among the people I corresponded with about this is Martha Gershun, a kidney donor who thinks and writes clearly, and has given me permission to quote some of what she said.

"I’m wondering if we find the presentation of the story troubling:  “Right-wing journalist and Temple Mount activist causes stir by announcing his kidney would go only to a Jew.”  We would react badly to a story that said:  “Right-wing Trump supporter says he will only give his kidney to a white man.”

"What if instead the stories were:  “Observant Jewish father of 8 wants to donate to a fellow Jew” and “Rural man from West Virginia seeks to help another in his community”?  Would we find those stories more acceptable?"

Part of the feeling that this is a bit complicated has to do with the fact that we don't (and maybe shouldn't) look gift horses in the mouth, i.e. we don't and maybe shouldn't delve deeply into the motivation of altruistic acts that do a lot of good. We should applaud good deeds even if they aren't performed by saints. (I blogged yesterday, about paying it forward, an umbrella term for doing good deeds in a spirit of gratitude for having ourselves benefited  from past good deeds performed by others. We generally don't find it necessary to condition our approval on precisely who receives the forward-paid gifts.)

So, while I'm not sorry to see that this statement by a kidney donor is a much discussed provocation, I'm inclined to think that a good deed remains a mitzvah even if not performed by a tzadik, as we might have said in our New York English when I was growing up.

I'll give the last word to a Haaretz op-ed, also in English:

 Is It Kosher to Donate Kidneys Only to Other Jews?  A well-known religious journalist in Israel declared the " -only" donation of his kidney. His act is imperfect, but not immoral by Robby Berman

+++++++++++++++

*On the algorithm used in Israel and elsewhere, see e.g.

Wednesday, January 15, 2020 Kidney Exchange in Israel (supported by Itai Ashlagi)


and


************
Update: related subsequent post 


Monday, May 29, 2023

Further progress on course allocation, by Budish, Gao, Othman, Rubinstein and Zhang

 Here are some new developments in the course allocation mechanism used initially in Wharton and now elsewhere.  It turns out that strategy-proofness in the (very) large doesn't imply strategyproofness in samples of realistic size, but this seems to be fixable (and profitable manipulations were not easy to find). The paper concludes with some far ranging thoughts on the econ-cs interface.

Practical algorithms and experimentally validated incentives for equilibrium-based fair division (A-CEEI)   by ERIC BUDISH, RUIQUAN GAO, ABRAHAM OTHMAN  AVIAD RUBINSTEIN, and QIANFAN ZHANG

Abstract: "Approximate Competitive Equilibrium from Equal Incomes (A-CEEI) is an equilibrium-based solution concept for fair division of discrete items to agents with combinatorial demands. In theory, it is known that in asymptotically large markets:

•For incentives, the A-CEEI mechanism is Envy-Free-but-for-Tie-Breaking (EF-TB), which implies that it is Strategyproof-in-the-Large (SP-L).

•From a computational perspective, computing the equilibrium solution is unfortunately a computationally intractable problem (in the worst-case, assuming PPAD≠FP).

We develop a new heuristic algorithm that outperforms the previous state-of-the-art by multiple orders of magnitude. This new, faster algorithm lets us perform experiments on real-world inputs for the first time. We discover that with real-world preferences, even in a realistic implementation that satisfies the EF-TB and SP-L properties, agents may have surprisingly simple and plausible deviations from truthful reporting of preferences. To this end, we propose a novel strengthening of EF-TB, which dramatically reduces the potential for strategic deviations from truthful reporting in our experiments. A (variant of ) our algorithm is now in production: on real course allocation problems it is much faster, has zero clearing error, and has stronger incentive properties than the prior state-of-the-art implementation"

Here's an intriguing passage:

"In Section 6 we use our manipulation-finding algorithm in combination with our fast A-CEEI finding algorithm to explore the plausibility of effective manipulations for students bidding in ACEEI. Originally, we had expected that since our mechanism satisfies the EF-TB and SP-L properties, it would at least be practically strategyproof — if even we don’t really understand the way our algorithm chooses among the many possible equilibria, how can a student with limited information learn to strategically bid in such a complex environment? 

"Indeed, in 2 out of 3 schools that we tested, our manipulation-finding algorithms finds very few or no statistically significant manipulations at all. However, when analyzing the 3rd school, we stumbled upon a simple and effective manipulation for (the first iteration of) our mechanism. We emphasize that although the manipulation is simple in hindsight, in over a year of working on this project we failed to predict it by analyzing the algorithm — the manipulation was discovered by the algorithm

"Inspired by this manipulation, we propose a natural strengthening of envy-free (discussed below), which we call contested-envy free. We encode the analogous contested EF-TB as a new constraint in our algorithm (specifically, the integer program for finding optimal budget perturbations). Fortunately, our algorithm is still very fast even with this more elaborate constraint. And, when we re-run our manipulation-finding experiments, we observe that contested EF-TB significantly reduces the potential for manipulations in practice."

...

"Conclusion:  In this work, we give a significantly faster algorithm for computing A-CEEI. Kamal Jain’s famous formulation “if your laptop cannot find it then neither can the market” [Papadimitriou 2007] was originally intended as a negative result, casting doubt on the practical implications of many famous economic concepts because of their worst-case computational complexity results. Even for course allocation, where a heuristic algorithm existed and worked in practice, Jain’s formulation seemed to still bind, as solving A-CEEI involved an intense day-long process with a fleet of high-powered cloud servers operating in parallel. The work detailed in this paper has significantly progressed what laptops can find: even the largest and most challenging real course allocation problems we have access to can now be solved in under an hour on a commodity laptop. 

"This significant practical improvement suggests that the relationship between prices and demand for the course allocation problem—and potentially other problems of economic interest with complex agent preferences and heterogeneous goods—may be much simpler than has been previously believed and may be far more tractable in practice than the worst-case theoretical bounds. Recalling Jain’s dictum, perhaps many more market equilibria can be found by laptops—or, perhaps, Walras’s original and seemingly naive description of how prices iterate in the real world may in fact typically produce approximate equilibria. 

"Our fast algorithm also opens the door for empirical research on A-CEEI, because we can now solve many instances and see how the solution changes for different inputs. We took it in one direction: empirically investigating the incentives properties of A-CEEI for the first time. For course allocation specifically, this faster algorithm opens up new avenues for improving student outcomes through experimentation. For instance, university administrators often want to subsidize some 6 group of students (e.g., second-year MBA students over first-year MBA students), but are unsure how large of a budget subsidy to grant those students to balance equity against their expectations. Being able to run more assignments with different subsidies can help to resolve this issue."

*************

Earlier related posts:

Thursday, April 23, 2009

Sunday, October 4, 2009

Thursday, May 30, 2013

Monday, August 3, 2015

Tuesday, June 9, 2020

Thursday, December 8, 2022

Three way liver exchange in Pakistan, reported in JAMA Surgery by Salman, Arsalan, and Dar, in collaboration with economist Alex Chan

 Here's an exciting account, just published in JAMA Surgery, of a three way liver exchange in Pakistan, achieved in part by collaboration with economist and market designer Alex Chan (who is on the job market this year).

Launching Liver Exchange and the First 3-Way Liver Paired Donation by Saad Salman, MD, MPH1; Muhammad Arsalan, MBBS2; Faisal Saud Dar, MBBS2, JAMA Surg. Published online December 7, 2022. doi:10.1001/jamasurg.2022.5440 (pdf)

Here are the first paragraphs:

"There is a shortage of transplantable organs almost everywhere in the world. In the US, about 6000 transplant candidates die waiting each year.1 In Pakistan, 30% to 50% of patients who needed a liver transplant are unable to secure a compatible donor, and about 10 000 people die each year waiting for a liver.2 Kidney paired donations, supported by Nobel Prize–winning kidney exchange (KE) algorithms,3 have enabled living donor kidneys to become an important source of kidneys. Exchanges supported by algorithms that systematically identify the optimal set of paired donations has yet to take hold for liver transplant.

"The innovation reported here is the successful implementation of a liver exchange mechanism4 that also led to 3 liver allotransplants and 3 hepatectomies between 3 incompatible patient-donor pairs with living donor–patient ABO/size incompatibilities. These were facilitated by one of the world’s first documented 3-way liver paired donations (LPD) between patient-donor pairs.

"Since 2018 and 2019, we have explored LPD as a strategy to overcome barriers for liver failure patients in Pakistan in collaboration with economist Alex Chan, MPH.2 With LPD, the incompatibility issues with relative donors can be solved by exchanging donors. The Pakistan Kidney and Liver Institute (PKLI) adopted a liver exchange algorithm developed by Chan4 to evaluate LPD opportunities that prioritizes clinical urgency (Model for End-stage Liver Disease [MELD] scores) while maximizing transplant-enabling 2-way or 3-way swaps that ensures that hepatectomies for every donor within each swap has comparable ex ante risk (to ensure fairness). As of March 2022, 20 PKLI liver transplant candidates had actively coregistered living and related but incompatible liver donors. Evaluating these 20 incompatible patient-donor pairs with the algorithm,4 we found 7 potential transplants by two 2-way swaps and the 3-way swap reported. In contrast to ad hoc manual identification of organ exchange opportunities, the hallmark of a scalable organ exchange program is the regular deployment of algorithms to systematically identify possible exchanges. Regular deployment of LPD algorithms is novel.

"A total of 6 procedures took place on March 17, 2022. Patient 1, a 57-year-old man, received a right liver lobe from donor 2, a 28-year-old coregistered donor of patient 2 (56-year-old man), who in turn received a right liver lobe from donor 3, a 35-year-old woman who was a coregistered donor of patient 3. Patient 3, a 46-year-old man, received a right liver lobe from donor 1, a 22-year-old woman who was a coregistered donor of patient 1, completing the cycle (Figure). Five PKLI consultant surgeons and 7 senior registrars led the hepatectomies and liver allotransplants; 6 operating rooms were used simultaneously. One month postsurgery, all patients and donors are robust with no graft rejection. All the donors are doing well in the follow-up visits and have shown no psychological issues."



Here's a sentence in the acknowledgements:

"We thank Alex Chan, MPH (Stanford University, Palo Alto, California), whose initiative and expertise in economics were the key driving forces for launching liver exchange."

*********
NB: this is a "Surgical Innovation" article, for which the journal requires that there be no more than three authors.

And here are the references cited:

1.
Chan  A, Roth  AE. Regulation of organ transplantation and procurement: a market design lab experiment. Accessed April 28, 2022. https://www.alexchan.net/_files/ugd/a47645_99b1d4843f2f42beb95b94e43547083b.pdf
2.
Salman  S, Gurev  S, Arsalan  M, Dar  F, Chan  A. Liver exchange: a pathway to increase access to transplantation. Accessed April 1, 2022. http://www.hhpronline.org/articles/2021/1/14/liver-exchange-a-pathway-to-increase-access-to-transplantation
3.
Henderson  D. On marriage, kidneys and the Economics Nobel. Wall Street Journal. October 15, 2012. Accessed March 5, 2022. https://www.wsj.com/articles/SB10000872396390443675404578058773182478536
4.
Chan  A. Optimal liver exchange with equipoise. Accessed April 23, 2022. https://www.alexchan.net/_files/ugd/a47645_36e252f4df0c4707b6431b0559b03143.pdf
5.
Hwang  S, Lee  SG, Moon  DB,  et al.  Exchange living donor liver transplantation to overcome ABO incompatibility in adult patients.   Liver Transpl. 2010;16(4):482-490. doi:10.1002/lt.22017PubMedGoogle ScholarCrossref
6.
Patel  MS, Mohamed  Z, Ghanekar  A,  et al.  Living donor liver paired exchange: a North American first.   Am J Transplant. 2021;21(1):400-404. doi:10.1111/ajt.16137PubMedGoogle ScholarCrossref
7.
Braun  HJ, Torres  AM, Louie  F,  et al.  Expanding living donor liver transplantation: report of first US living donor liver transplant chain.   Am J Transplant. 2021;21(4):1633-1636. doi:10.1111/ajt.16396

 ********

Here's a Stanford story on this collaboration:

Stanford student devises liver exchange, easing shortage of organs. A rare three-way exchange of liver transplants in Pakistan was made possible with a new algorithm developed by a Stanford Medicine student.  by Nina Bai

"The liver exchange idea actually came out of a term paper in a first-year market design class at Stanford," Chan said.

"As he learned more about liver transplants, Chan realized there were important biological and ethical differences from kidney transplants. 

...

"Instead of just finding compatible swaps, we want to find swaps that prioitize the most urgent patients first in order to prevent the most deaths," Chan said.

*******

Here are some contemporaneous stories from March in the newspaper Dawn (now that the JAMA embargo on the story is lifted):

Mar 18, 2022 — A highly-trained team of the surgeons headed by PKLI Dean Prof Faisal Dar had performed liver transplants at the institute and other members ...