Kidney and liver donation: the movie trailer for Abundant

 You can see the 1.5-minute trailer for the movie here, or here.

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Earlier: 

Tuesday, September 24, 2024

Abundant: a moving documentary about living organ donors

Abundant: a moving documentary about living organ donors

This past weekend I streamed a preview of a new movie about  living organ donors, kidneys (mostly) and some livers. It's called Abundant, and early in the project it described itself as "a documentary about the human experience of giving."

The movie consists mostly of the stories of donors, the experiences they had, and how they felt and feel about the lives they saved, and their connection to other donors, who are able to share the profound satisfaction that donation has given them. The stories are interspersed with commentary from various kinds of experts. (I was on the preview list since I get a good 60 seconds of commentary:)

The movie is also about chains, starting with kidney exchange chains, since many of the donors are nondirected donors who started chains.

At a more metaphorical level, the movie talks about chains of connections. One of the people they interview is Stephen Dubner, the host of the podcast Freakonomics.  He interviewed me on Freakonomics about kidney exchange, that podcast was heard by Ned Brooks, who was moved to donate a kidney (which started a chain) and then to start the National Kidney Donor Organization (NKDO).  Dubner interviewed him on Freakonomics too, and those Freakonomics interviews contributed more links to the chain.

This movie is destined to be a link in that chain too.

With more than half a million people on dialysis in the U.S., almost everyone knows or knows of someone who needs a kidney transplant.  This is the movie for all of them, with stories that may help them find a donor.  And who knows how many people will create new links in that chain.

It's a movie about how generosity creates abundance.

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earlier:

Wednesday, February 21, 2024

Nondirected living kidney donors--Abundant (the movie, in progress)

Friday, February 26, 2016

A Freakonomics listener was inspired to become a non-directed kidney donor by the podcast on kidney exchange

Kidney exchange chains between Israel and Cyprus

 Israel Hayom has the story. (Itai Ashalgi's software gets a shout-out):

Unprecedented Israel-Cyprus kidney exchange saves 8 lives. Cross-border medical collaboration showcases the power of organ donation and transplant innovation.    By  Eleanor Favriker/Makor Rishon

"In a remarkable display of international medical cooperation, eight kidney transplants have been performed across Israel and Cyprus as part of a pioneering cross-border organ exchange program. The intricate operation, involving multiple hospitals and a meticulously coordinated logistics effort, was made possible by two altruistic donors who approached the National Transplant Center, initiating a "transplant chain."

"The joint operation, conducted on Monday, saw five procedures taking place in Israel and three in Cyprus. The National Transplant Center matched the pairs using specialized computer software, drawing from an international database containing incompatible family member pairs.

"Starting at 5:00 a.m., kidneys harvested at Hadassah and Soroka hospitals were transported by ambulance to the airport and flown to Cyprus. Concurrently, another kidney from Hadassah was transferred to Soroka, while one from Beilinson was sent to Hadassah. At 2:00 p.m., two kidneys arrived from Cyprus, destined for Beilinson and Hadassah. By 6:00 p.m., all transplants were completed in both countries, with recipients in good condition and new kidneys functioning.

"In Israel, three transplants occurred at Hadassah, one at Beilinson, and one at Soroka, with an additional Hadassah transplant performed a day earlier. In total, Israel saw 10 surgeries: five kidney removals and five transplants.

"Professor Shlomo Mor Yosef, chairman of the Steering Committee, said, "I commend the cooperation between Israel and Cyprus. These exchanges provide solutions for patients with antibodies. I urge every family with a patient needing a kidney transplant to join the exchange database if no match is found among them."

"Dr. Tamar Ashkenazi commented, "This marks our first two-way kidney exchange with Cyprus. Their single transplant center in Nicosia performed six surgeries in one day, supported by a surgeon from England. I'd like to thank Ms. Rona Simon, who manages our exchange database, facilitating over 60 successful cross-transplants annually. Israel maintains similar programs with the Czech Republic, Austria, and the United Arab Emirates."

Kidney transplants for cats

 Kidney transplants for cats are a thing, and they all take the form of kidney exchange with a very short chain, in which the lives of two cats are saved. The donor cat is either an unadopted cat from a 'kill shelter,' or a veteran of a medical research trial, who (as the story below says) would otherwise face a "bleak future." But when such a cat becomes a living kidney donor, it is adopted into the family of the cat who receives the transplant (and I guess it goes without saying that they love cats..)

The Washington Post has the story

.Cat kidney transplants: For some, the pricey procedure is well worth it. The surgery can cost up to $25,000. “I just spent $17,000 on my roof, and I love my cat a lot more than my roof,” one person said.  By Marlene Cimons

"Segal, then living in the Boston area, drove his cat to the University of Pennsylvania School of Veterinary Medicine in Philadelphia where Despy underwent a kidney transplant in 2018. Today, Despy is thriving. So is Stevie, the kidney donor cat from a local shelter that Segal agreed to adopt as part of the renal transplant.

...

"Chronic kidney disease is one of the most common conditions in aging cats and a leading cause of death. The disease can be heritable, afflicting young cats such as Despy, and can result from toxin exposure, such as eating lilies.

...

"Like humans, cats have two kidneys, which filter waste from the body, and can live with just one if that kidney is healthy.

"Kidney transplants in cats began more than 25 years ago, although they still are rare, and only three facilities perform them: Penn Vet, the University of Wisconsin School of Veterinary Medicine and the University of Georgia College of Veterinary Medicine.

"Penn Vet has performed 185 transplants since 1998, the Georgia school more than 40 since 2009, and Wisconsin 87 since 1996.

...

"Many pet health insurance companies will cover some of the costs for the recipient, but usually not for the donor because “the donor is not the insured pet,” according to the North American Pet Health Insurance Association. The cost for the donor surgery to harvest the kidney is about 25 percent of the $25,000 total, Aronson says.

...

"Matching is easier for cats than it is for humans needing a transplant because there are only two blood types among all cats.

"Donors come from cat research breeding facilities or shelters, where they might otherwise have a bleak future, and families whose cats undergo transplants must adopt the donors. “For the cost of a kidney, [the donor cats] get to move in with a cat-loving household and are universally loved by their new adoptive families,” Schmiedt says.

...

"Transplants other than kidneys in pets aren’t viable because most require the death of the donor. Kidney transplants in dogs can be challenging because, unlike cats, they often suffer problems with immunosuppression, says Aronson, who has performed three. (The dogs survived but did not do as well long-term as cats, she says.)

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Earlier

Monday, November 23, 2020

Colin Sullivan on organ transplant policy (and on the job market this year)

His job market paper is an experiment with an exceptionally creative design. (Spoiler: it involves a cat actually getting a kidney transplant.) 

Eliciting Preferences Over Life And Death: Experimental Evidence From Organ Transplantation by Colin by D. Sullivan

Recent kidney transplant papers

 Here are two new papers on kidney exchange that caught my eye, and one on incentivizing deceased donation by prioritizing registered donors on the deceased donor waiting list.

This one concerns organizing international kidney exchanges between countries while making sure that each one gets their fair share. (All exchanges are between 2 pairs.)

Benedek, Márton, Péter Biró, Daniel Paulusma, and Xin Ye. "Computing balanced solutions for large international kidney exchange schemes." Autonomous Agents and Multi-Agent Systems 38, no. 1 (2024): 1-41.

Abstract: To overcome incompatibility issues, kidney patients may swap their donors. In international kidney exchange programmes (IKEPs), countries merge their national patient–donor pools. We consider a recently introduced credit system. In each round, countries are given an initial “fair” allocation of the total number of kidney transplants. This allocation is adjusted by a credit function yielding a target allocation. The goal is to find a solution that approaches the target allocation as closely as possible, to ensure long-term stability of the international pool. As solutions, we use maximum matchings that lexicographically minimize the country deviations from the target allocation. We perform, for the first time, a computational study for a large number of countries. For the initial allocations we use two easy-to-compute solution concepts, the benefit value and the contribution value, and four classical but hard-to-compute concepts, the Shapley value, nucleolus, Banzhaf value and tau value. By using state-of-the-art software we show that the latter four concepts are now within reach for IKEPs of up to fifteen countries. Our experiments show that using lexicographically minimal maximum matchings instead of ones that only minimize the largest deviation from the target allocation (as previously done) may make an IKEP up to 54% more balanced.

"We consider IKEPs in the setting of European KEPs which are scheduled in rounds, typically once in every three months.

...

"We first note that the search for an optimal exchange scheme can be done in polynomial time for 2-way exchanges (matchings) but becomes NP-hard as soon as 3-way exchanges are permitted."

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Here's a paper that reports simulations on Using deceased donor kidneys to start living donor kidney exchange chains

Verma, Utkarsh, Nayaran Rangaraj, Viswanath Billa, and Deepa Usulumarty. "Long term simulation analysis of deceased donor initiated chains in kidney exchange programs." Health Systems (2023): 1-12.

ABSTRACT: Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a DD donates kidneys directly to a DD wait-list. The idea of initiating an exchange chain starting from a DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates DD-initiated chains, considering both paired exchange registry and DD allocations simultaneously and addressing the overlap issue between the exchange registry and DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of DDs, these chains can significantly increase potential transplants.

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And here's the paper on incentivizing registration to be a deceased donor.

Li, Mengling, and Yohanes E. Riyanto. "Incentivizing Organ Donation Under Different Priority Rules: The Role of Information." Management Science (2024).

Abstract: This paper examines the incentive to register for deceased organ donation under alternative organ allocation priority rules, which may prioritize registered donors and/or patients with higher valuations for organ transplantation. Specifically, the donor priority rule grants higher priority on the organ waiting list to those who have previously registered as donors. The dual-incentive priority rules allocate organs based on donor status, followed by individual valuations within the same donor status, or vice versa. Both theoretical and experimental results suggest that the efficacy of the donor priority rule and the dual-incentive priority rules critically depends on the information environment. When organ transplantation valuations are unobservable prior to making donation decisions, the hybrid dual-incentive rules generate higher donation rates. In contrast, if valuations are observable, the dual-incentive priority rules create unbalanced incentives between high- and low-value agents, potentially undermining the efficacy of the hybrid dual-incentive rules in increasing overall donation rates.

Nondirected living kidney donors--Abundant (the movie, in progress)

 Abundant is a movie in the making,  a documentary about altruism, focused on non-directed living kidney donors, who start kidney exchange chains. It isn't done yet, but now they are in the editing process...

"Abundant is a feature-length documentary film about the complex, human experience of giving.  To fully understand giving, Abundant enters the world of extreme altruism.  And there are no more extreme altruists than non-directed living kidney donors.  These rare individuals give a kidney away to a complete stranger.  It’s all risk, no reward.  Or is it? 

"Abundant features true stories of non-directed kidney donors recorded live on stage at the performance art show CrowdSource for Life.  Their stories illustrate the unimaginable impact of extreme giving.  It’s obvious their kidney donations saved another person’s life, but there is so much more involved.

"Insights from experts from the worlds of economics, spirituality, business, the arts, psychology and neuroscience, frame and explain the altruistic psyche. In his interview for Abundant, Buddhist monk Bhante Sujatha described giving with a literal translation from his Sri Lankan language, Sinhala.  In Sinhala, giving means, “It leaves my hand.”  That’s a clear, simple and elegant concept.  Yet so many of us struggle with the genuine act of giving and the abundance required to give openheartedly.

"Through stories, commentary and experiences, Abundant explores how our culture struggles with abundance and what we can do to become more altruistic as a community."

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Update: here's a link to join the email list for updates on the movie:  https://abundantmovie.com/

Kidney exchange (and other bits of market design) in the New York Times

 Peter Coy, the veteran New York Times economics columnist, writes about kidney exchange, after an interview/conversation sparked by a recent working paper of mine, Market Design and Maintenance. (He's a rare economic journalist who reads economists' papers.)

Here's his column, published yesterday afternoon:

The Economist Who Helped Patients Get New Kidneys, Feb. 5, 2024, 3:00 p.m. ET, By Peter Coy

He's also a rare interviewer: his column includes the names of more of my coauthors than I can recall in any other interview. In order of appearance: Tayfun Sonmez and Utku Unver, Frank Delmonico, Susan Saidman, Mike Rees (implicitly) when he names Mike's nonprofit Alliance for Paired Kidney Donation, and Elliott Peranson.  Market design is, after all, a team sport.

Here's his concluding paragraph:

"What is it like to straddle the worlds of academia and practice? I asked. “It takes a lot of patience,” he said. “Market design is outward-facing. I learn from trying to persuade people who aren’t economists. It’s a lot of fun also. Sometimes you have to go beyond your completely reliable scientific knowledge.”

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Earlier post:

Monday, December 11, 2023

Market Design and Maintenance (new NBER working paper, from a conference)

Paying it forward

 Scott Cunningham, an economist who devotes a lot of his efforts to providing public goods, recently had a post on the phrase "paying it forward." He writes that he connected it with a movie with a similar name, but has recently come to view it differently (for reasons I find too embarrassing to quote, but related to the fact that I use the phrase now and then.)

Wikipedia says "Pay it forward is an expression for describing the beneficiary of a good deed repaying the kindness to others instead of to the original benefactor."  It goes on to say "Robert Heinlein's 1951 novel Between Planets helped popularize the phrase."  I could have first seen it there, as I read much of Heinlein's science fiction when I was a boy.

My associations with the phrase now mostly come from the motivations and actions of some living kidney donors, particularly in kidney exchange chains.

The phrase is certainly is evocative of what we do so much of in academia (when we're doing academia well): it describes the relationship between studying and teaching, and between teachers and students.

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Scott's post announced that, as part of paying things forward, he's funding a prize for young economists.

Freakonomics replay and update on kidney exchange and organ donation

 Freakonomics Radio yesterday revisited some of their old podcasts about kidney exchange. In one, they interview me, and in another, they interview Ned Brooks, who listened to that interview and went on to become a non-directed kidney donor and to found an organization to support other kidney donors, the NKDO, National Kidney Donation Organization.  You can listen and/or read the transcript at this link:

EPISODE 209

Make Me a Match (Update)

"Sure, markets work well in general. But for some transactions — like school admissions and organ transplants — money alone can’t solve the problem. That’s when you need a market-design wizard like Al Roth. Plus: We hear from a listener who, inspired by this episode, made a remarkable decision.

"Last month, the federal government announced plans to modernize the U.S. organ-donation system. They want to speed up the process by which organ-transplant patients are matched with donated organs, and they also want to reduce racial inequities in the system. When we saw this news, we decided to go into our archive and put together the episode you’re about to hear. It’s a mashup of a 2015 episode, No. 209, called “Make Me a Match,” and a portion of a 2016 episode, No. 237, which includes a personal story from a listener who was inspired by that earlier episode to make a remarkable decision. All the relevant facts and figures have been updated. As always, thanks for listening."

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Here are my previous posts on Freakonomics episodes.

The power of kidneys, altruism, and books. (And recommendation of a doctor in the UK)

 Here's a story, about kidneys and about books, in inews.co.uk:

‘It’s a gift with no conditions attached’: Why I donated my kidney to a person I’ll never meet. 250 people die each year in the UK because there are not enough kidneys available. So when GP Richard Armitage discovered altruistic donation was possible, he gave away an organ. By Tom Ough

"Despite being a GP, Richard Armitage had spent most of his career unaware that altruistic donations were possible. In this respect, Armitage, 34, was like many of his colleagues in the medical profession. That changed in 2017. Armitage, visiting the Nobel Laureate Museum Stockholm, bought a book by Alvin Roth, an economist who won a Nobel Prize in 2012. The book was Who Gets What — and Why: The New Economics of Matchmaking and Market Design, and in it Roth wrote how we allocate things within markets that aren’t dictated by money.

"Examples include the allocation of children to schools, doctors to hospitals, and kidneys to people with end-stage renal disease. Roth discussed what is known as non-directed altruistic kidney donations – in short, kidneys donated to strangers. Sitting on the plane home, Armitage read the book with fascination. When he returned to Nottingham he checked the NHS website to see whether non-directed altruistic kidney donation was possible in the UK. It was.

...

"In 2018 altruistic donors began being routinely added to the UK Living Kidney Sharing Scheme (UKLKSS), which oversees this sharing of organs by living donors. Apparently as a result of the move, in 2019 there was a 60 per cent rise in altruistic donations – from 124 to 183. Twenty-eight per cent of kidney transplants are now from living donors.

...

"It seemed a good application of the kind of moral philosophy that Armitage had discovered the same year, 2017, when he read Famine, Affluence and Morality. It is an influential essay in which Peter Singer, an Australian philosopher, argued that the West should be donating far more resources to humanitarian causes.

...

"All of Armitage’s intellectual discovery, including his reading of Roth’s writing on kidney donation, happened in one year, 2017 – also the year that Armitage finished his GP training. It marked the end of “a 10-year head-down slog” that began with the first day of medical school. “After I passed my last exam, it felt like I finally lifted my head up and asked: ‘But why am I doing this?’”

"And so Armitage’s first conversation with his regional kidney transplant centre was followed by an appointment with a Living Donor Nurse, who explained what donation would entail: the testing, the preparation, the surgery. Armitage was invited to speak to his loved ones and consider whether he was ready; it turned out he wasn’t.

"There were several hold-ups. At first, Armitage felt the beginning of his GP career was the wrong time to take weeks off work. Then Covid stalled the NHS’s kidney-sharing scheme. Armitage still wanted to donate his kidney, and successfully underwent a battery of investigations: a renal tract ultrasound scan, an electrocardiogram, chest X-ray, various fasted blood tests, and an X-ray of his kidney. As per the requirements of the donation scheme, Armitage met a clinical psychologist to discuss his state of mind, put the psychologist in touch with a loved one in order to independently assess his state of mind, and met a representative of the Human Tissue Authority to ensure that he was not donating his kidney under duress or for financial gain.

...

"Armitage spent several weeks in Ukraine as part of his work for the charity UK-Med, which sent British medics to deliver emergency healthcare. “That obviously meant I couldn’t continue with the donation process,” he says with some understatement. But when he got home, he told the donor team he was ready. “Can we crack on?”, he asked.

"The operation was on 23 November. Everything was in place; Armitage was part of a chain on which three people with end-stage renal disease were due a kidney.

...

"And just before he was discharged – three days after surgery, having convinced the hospital staff he was ready to take care of himself – he was informed that all the recipients in the chain now had working kidneys. “That was a very meaningful moment that made it all worthwhile,” says Armitage."

Kidney exchange collaboration between Stanford and APKD

 I recently had occasion to review the long collaboration between my Stanford colleagues and Mike Rees and the Alliance for Paired Kidney Donation. It turns out that, together with other coauthors, Mike and his APKD colleagues have written well over a dozen papers with me and my colleagues at Stanford.  (My own collaboration with Mike and APKD goes back to when Itai Ashlagi and I were still in Boston, where my earliest papers on kidney exchange were with  Tayfun Sönmez and Utku Ünver, and with Frank Delmonico and his colleagues at the New England Program for Kidney Exchange.)

Here's the list I came up with, probably not exhaustive:

Mike Rees/APKD collaborations with Stanford scholars (Ashlagi, Melcher, Roth, Somaini)

 1. Rees, Michael A., Jonathan E. Kopke, Ronald P. Pelletier, Dorry L. Segev, Matthew E. Rutter, Alfredo J. Fabrega, Jeffrey Rogers, Oleh G. Pankewycz, Janet Hiller, Alvin E. Roth, Tuomas Sandholm, Utku Ünver, and Robert A. Montgomery, “A Non-Simultaneous Extended Altruistic Donor Chain,” New England Journal of Medicine, 360;11, March 12, 2009, 1096-1101. https://www.nejm.org/doi/full/10.1056/NEJMoa0803645

2.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “Nonsimultaneous Chains and Dominos in Kidney Paired Donation – Revisited,” American Journal of Transplantation, 11, 5, May 2011, 984-994 http://www.stanford.edu/~alroth/papers/Nonsimultaneous%20Chains%20AJT%202011.pdf

3.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “NEAD Chains in Transplantation,” American Journal of Transplantation, December 2011; 11: 2780–2781. http://web.stanford.edu/~iashlagi/papers/NeadChains2.pdf

4.     Wallis, C. Bradley, Kannan P. Samy, Alvin E. Roth, and Michael A. Rees, “Kidney Paired Donation,” Nephrology Dialysis Transplantation, July 2011, 26 (7): 2091-2099 (published online March 31, 2011; doi: 10.1093/ndt/gfr155, https://academic.oup.com/ndt/article/26/7/2091/1896342/Kidney-paired-donation

5.     Rees, Michael A.,  Mark A. Schnitzler, Edward Zavala, James A. Cutler,  Alvin E. Roth, F. Dennis Irwin, Stephen W. Crawford,and Alan B.  Leichtman, “Call to Develop a Standard Acquisition Charge Model for Kidney Paired Donation,” American Journal of Transplantation, 2012, 12, 6 (June), 1392-1397. (published online 9 April 2012 http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2012.04034.x/abstract )

6.     Anderson, Ross, Itai Ashlagi, David Gamarnik, Michael Rees, Alvin E. Roth, Tayfun Sönmez and M. Utku Ünver, " Kidney Exchange and the Alliance for Paired Donation: Operations Research Changes the Way Kidneys are Transplanted," Edelman Award Competition, Interfaces, 2015, 45(1), pp. 26–42. http://pubsonline.informs.org/doi/pdf/10.1287/inte.2014.0766

7.     Fumo, D.E., V. Kapoor, L.J. Reece, S.M. Stepkowski,J.E. Kopke, S.E. Rees, C. Smith, A.E. Roth, A.B. Leichtman, M.A. Rees, “Improving matching strategies in kidney paired donation: the 7-year evolution of a web based virtual matching system,” American Journal of Transplantation, October 2015, 15(10), 2646-2654 http://onlinelibrary.wiley.com/enhanced/doi/10.1111/ajt.13337/ (designated one of 10 “best of AJT 2015”)

8.     Melcher, Marc L., John P. Roberts, Alan B. Leichtman, Alvin E. Roth, and Michael A. Rees, “Utilization of Deceased Donor Kidneys to Initiate Living Donor Chains,” American Journal of Transplantation, 16, 5, May 2016, 1367–1370. http://onlinelibrary.wiley.com/doi/10.1111/ajt.13740/full

9.     Michael A. Rees, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Alejandra Cicero, Laurie J. Reece, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Samay Jain, Miguel Tan and Siegfredo R. Paloyo, “Kidney Exchange to Overcome Financial Barriers to Kidney Transplantation,” American Journal of Transplantation, 17, 3, March 2017, 782–790. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14106/full  

a.     M. A. Rees, S. R. Paloyo, A. E. Roth, K. D. Krawiec, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, “Global Kidney Exchange: Financially Incompatible Pairs Are Not Transplantable Compatible Pairs,” American Journal of Transplantation, 17, 10, October 2017, 2743–2744. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14451/full

b.     A. E. Roth, K. D. Krawiec, S. Paloyo, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, and M. A. Rees, “People should not be banned from transplantation only because of their country of origin,” American Journal of Transplantation, 17, 10, October 2017, 2747-2748. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14485/full

c.      Ignazio R. Marino, Alvin E. Roth, Michael A. Rees; Cataldo Doria, “Open dialogue between professionals with different opinions builds the best policy, American Journal of Transplantation, 17, 10, October 2017, 2749. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14484/full

10.  Danielle Bozek, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Laura Basagoitia, Robert J. Brunner, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Puneet Sindhwani, Jorge Ortiz, Miguel Tan, and Siegfredo R. Paloyo, Michael A. Rees, “The Complete Chain of the First Global Kidney Exchange Transplant and 3-yr Follow-up,” European Urology Focus, 4, 2, March 2018, 190-197. https://www.sciencedirect.com/science/article/pii/S2405456918301871

11.  Itai Ashlagi, Adam Bingaman, Maximilien Burq, Vahideh Manshadi, David Gamarnik, Cathi Murphey, Alvin E. Roth,  Marc L. Melcher, Michael A. Rees, ”The effect of match-run frequencies on the number of transplants and waiting times in kidney exchange,” American Journal of Transplantation, 18, 5, May 2018,  1177-1186, https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.14566

12.   Stepkowski, S. M., Mierzejewska, B., Fumo, D., Bekbolsynov, D., Khuder, S., Baum, C. E., Brunner, R. J., Kopke, J. E., Rees, S. E., Smith, C. E., Ashlagi, I., Roth, A. E., Rees, M. A., “The 6-year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program- a retrospective study,” Transplant international 32: 839-853. 2019. https://onlinelibrary.wiley.com/doi/10.1111/tri.13423

13.   Roth, Alvin E., Ignazio R. Marino, Obi Ekwenna, Ty B. Dunn, Siegfredo R. Paloyo, Miguel Tan, Ricardo Correa-Rotter, Christian S. Kuhr, Christopher L. Marsh, Jorge Ortiz, Giuliano Testa, Puneet Sindhwani, Dorry L. Segev, Jeffrey Rogers, Jeffrey D. Punch, Rachel C. Forbes, Michael A. Zimmerman, Matthew J. Ellis, Aparna Rege, Laura Basagoitia, Kimberly D. Krawiec, and Michael A. Rees, “Global Kidney Exchange Should Expand Wisely, Transplant International, September 2020, 33, 9,  985-988. https://onlinelibrary.wiley.com/doi/full/10.1111/tri.13656

14.  Vivek B. Kute, Himanshu V. Patel, Pranjal R. Modi, Sayyad J. Rizvi, Pankaj R. Shah, Divyesh P Engineer, Subho Banerjee, Hari Shankar Meshram, Bina P. Butala, Manisha P. Modi, Shruti Gandhi, Ansy H. Patel, Vineet V. Mishra, Alvin E. Roth, Jonathan E. Kopke, Michael A. Rees, “Non-simultaneous kidney exchange cycles in resource-restricted countries without non-directed donation,” Transplant International,  Volume 34, Issue 4, April 2021,  669-680  https://doi.org/10.1111/tri.13833

15.   Afshin Nikzad, Mohammad Akbarpour, Michael A. Rees, and Alvin E. Roth “Global Kidney Chains,” Proceedings of the National Academy of Sciences, September 7, 2021 118 (36) e2106652118; https://doi.org/10.1073/pnas.2106652118 .

16.    Alvin E. Roth, Ignazio R. Marino, Kimberly D. Krawiec, and Michael A. Rees, “Criminal, Legal, and Ethical Kidney Donation and Transplantation: A Conceptual Framework to Enable Innovation,” Transplant International  (2022), 35: doi: 10.3389/ti.2022.10551, https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10551/full

17.   Ignazio R. Marino, Alvin E. Roth, and Michael A. Rees, “Living Kidney Donor Transplantation and Global Kidney Exchange,” Experimental and Clinical Transplantation (2022), Suppl. 4, 5-9. http://www.ectrx.org/class/pdfPreview.php?year=2022&volume=20&issue=8&supplement=4&spage_number=5&makale_no=0

18.  Agarwal, Nikhil, Itai Ashlagi, Michael A. Rees, Paulo Somaini, and Daniel Waldinger. "Equilibrium allocations under alternative waitlist designs: Evidence from deceased donor kidneys." Econometrica 89, no. 1 (2021): 37-76.

And here’s a report of work in progress:

The First 52 Global Kidney Exchange Transplants: overcoming multiple barriers to transplantation by MA Rees, AE Roth , IR Marino, K Krawiec, A Agnihotri, S Rees, K Sweeney, S Paloyo, T Dunn, M Zimmerman, J Punch, R Sung, J Leventhal, A Alobaidli, F Aziz, E Mor, T Ashkenazi, I Ashlagi, M Ellis, A Rege, V Whittaker, R Forbes, C Marsh, C Kuhr, J Rogers, M Tan, L Basagoitia, R Correa-Rotter, S Anwar, F Citterio, J Romagnoli, and O Ekwenna.  Transplantation: September 2022 - Volume 106 - Issue 9S - p S469 doi: 10.1097/01.tp.0000887972.53388.77  https://journals.lww.com/transplantjournal/Fulltext/2022/09001/423_9__The_First_52_Global_Kidney_Exchange.697.aspx

Kidney exchange in The Times of India

 The Times of India covers my talk at the Indian Society of Transplantation meeting:

Alvin Roth for legal boost to kidney exchange pool in India by Chaitanya Deshpande, Oct 15, 2022c

 The site makes it hard to extract text, but here's a photo of some comments, which make me hope that some action may be taken:

Update: 

Prospects for improving kidney exchange in France

A recent article in Néphrologie & Thérapeutique simulates how kidney exchange in France could possibly be made substantially more effective, following liberalizations in the law. (The article is in French, but also has an English abstract.) A promising feature is that the article is a collaboration between physicians and market design economists.

Perspectives pour une évolution du programme de don croisé de reins en France

Perspectives for future development of the kidney paired donation programme in France by Julien Combe, Victor Hiller, Olivier Tercieux,  Benoît Audry, Jules Baudet, Géraldine   Malaquin, François Kerbaul, Corinne Antoine, Marie-Alice Macher, Christian Jacquelinet, Olivier Bastien, and Myriam Pastural

Abstract: "Almost one third of kidney donation candidates are incompatible (HLA and/or ABO) with their directed recipient. Kidney paired donation allows potential donors to be exchanged and gives access to a compatible kidney transplant. The Bioethics Law of 2011 authorised kidney paired donation in France with reciprocity between 2 incompatible “donor-recipient” pairs. A limited number of transplants have been performed due to a too restricted authorization compared to other European practices. This study presents the perspectives of the new Bioethics Law, enacted in 2021, which increases the authorised practices for kidney paired donation in France. The two simulated evolutions are the increase of the number of pairs involved in a kidney paired donation to 6 (against 2 currently) and the use of a deceased donor as a substitution to one of living donor. Different scenarios are simulated using data from the Agence de la Biomedecine; incompatible pairs registered in the kidney paired donation programme in France between December 2013 and February 2018 (78 incompatible pairs), incompatible transplants performed during the same period (476 incompatible pairs) and characteristics of deceased donors as well as proposals made over this period. Increasing the number of pairs has a limited effect on the number of transplants, which increases from 18 (23% of recipients) in the current system to 25 (32% of recipients) when 6 pairs can be involved. The use of a deceased donor significantly increases the number of transplants to 41 (52% of recipients). This study makes it possible to evaluate the increase in possibilities of kidney transplants by kidney paired donation following the new bioethics law. A working group and an information campaign for professionals and patients will be necessary for its implementation."

While the paper focuses on the situation in France, it's opening lines could have been written anywhere:

"La France, comme l’ensemble des pays du monde, souffre d’une pénurie de greffons rénaux de sorte que le nombre de malades en attente d’une greffe de rein ne cesse de croître." [France, like all countries in the world, suffers from a shortage of kidney transplants so that the number of patients waiting for a kidney transplant continues to grow."

Here's hoping that the authors will succeed in their plans to use deceased-donor initiated chains to save more lives in France.

*********

Earlier related posts:

Sunday, April 3, 2022

Kidney Paired Donation Chains Initiated by Deceased Donors

Monday, November 22, 2021

A naturally occurring deceased-donor-initiated kidney exchange chain, by Maghen and Veale

Sunday, August 23, 2020

More on Deceased donors as non‐directed donors in kidney exchange chains

Tuesday, August 7, 2018

Deceased donor chains: Market design language is entering transplantation

Monday, April 11, 2016

Using deceased donor kidneys to start living donor kidney exchange chains

 

The Future of Living Donor Kidney Transplants May 7, 2022 (online webinar hosted at U. Chicago)

Yesterday I posted about the increasing incidence and prevalence of end stage renal disease. 

On Saturday I'll be taking part in a medical education webinar, open to the general public, on avenues to increase the availability of safe, ethical and legal kidney transplants.  Some will find it controversial*, even repugnant, since one of the big topics is the ethics of compensating kidney donors. (I'll be talking about some  of the incremental improvements that have been and can be pursued while that discussion goes on. Some of those have also had to overcome some opposition...)

There's an all-star cast of speakers.

The Future of Living Donor Kidney Transplants

May 7, 2022; Virtual; Admission Is Free (join at the link above)

7AM-10 AM (PDT); 9AM-12Noon (CDT); 10AM-1PM (EDT)

Session 1: Ethics of Gifting or Compensation of Donors
Topic	Presenter (s)	Comments	Time (mins.)
			Item	Cu mul.
Ethics of Compensating (“Rewarding”) Donors	Janet Radcliffe Richards	World renown philosopher/ethicist. (Oxford). Book: the ethics of transplants why careless thought costs lives	30	30
Questions, Comments, and Recap Session 1	CON: Asif Sharfuddin M.D. FASN FAST PRO: Sally Satel M.D. M.S.		30	60
Session 2: Living Donor Transplant Issues
Cost-Benefit Analysis of Compensating (“Rewarding” Kidney Donors	Frank McCormick Ph.D.	How the Government Can End the Kidney Shortage and Save More than 40,000 Kidney Failure Patients Each Year by Compensating Living Kidney Donors. Total economic value to kidney recipients is $76B/yr. Net savings to the taxpayers is $7B/yr.	15	75
Current Status and Future Developments in Kidney Exchange Programs	Alvin Roth, Ph.D. Nobel Laurette	Living donor organs are being increasingly allocated by paired and exchange organ programs; This is the only major technical improvement in transplantation in years;	15	90

Session 2: Living Donor Transplant Issues Cont’d
Decreasing Barriers and Increasing Access for Living Donation	Cody Maynard; Independent Living Donor Advocate (NKDO)	Immediate actions we can take to increase the pool of living donors.	10	100
Discussion and Recap of Session 2 (John Fung, M.D, Ph.D.)			10	110
Break			10	120
Session 3: More Living Donor Transplant Issues
Experiences of a Living Kidney Donor;	Martha Gershun, MBA	Author of a recent book with J.D. Lantos MD: Kidney to Share.	10	130
U.S. Public Attitudes Towards Compensating Donors	Thomas Peters M.D.	Two peer reviewed studies show that 70% of US population support compensating donors $50K.	10	140
Risk and Safeguards for Living Donors	Arthur Matas, M.D., Ph.D.	Screening donors is essential. Risks are small but not zero.	15	155
The Limits of Increased Counts of Deceased Donor Transplants	John P. Roberts M.D.	Ignorance is common: Increasing the Deceased Donor pool is constrained by the limits of brain- dead donors; <2% of U.S. deaths.	10	165
WaitList Zero’s role in Living Donation	Josh Morrison J.D.; Founder of WaitList Zero	“Thanks for helping us, we were lost!” comment by a recipient, pointing to the need for education regarding living donors.	10	175
Discussion and Recap Session 3 (Thomas Peters M.D.)			10	185
Recap and Summary of the Symposium Glenn Chertow M.D., MPH			20	205

* Part of the controversy is that some advertisements for the webinar were deleted, here are some tweets on the subject: