Market Design

Thursday, February 10, 2011

Experimental conference and summer school at Barcelona in June

There will be lots to learn...

2nd LeeX International Conference on Theoretical and Experimental Macroeconomics, June 10-11, 2011at Universitat Pompeu Fabra. Keynote speakers are:Jean-Robert Tyran, University of Wiena, and Jordi Gali, CREI UPF. The conference organizers are: John Duffy, University of Pittsburgh Frank Heinemann, Technical University of Berlin, Rosemarie Nagel , Universitat Pompeu Fabra. Deadline Friday, April 1, 2011.

Summer school: Fourth Barcelona LeeX Experimental Summer School in Macroeconomics, June 6-9 2011 at Universitat Pompeu Fabra. The summer school organizers are: John Duffy, University of Pittsburgh Frank Heinemann, Technical University of Berlin, Rosemarie Nagel , Universitat Pompeu Fabra. Deadline 18 April 2011.

Wednesday, February 9, 2011

Wake Forest coach donates a kidney to player

The story is here, it was published yesterday, and I saw it only after yesterday's blog post of organ donation stories.

"When a coach says he would do anything for his players, it sounds like a cliché.

"Then there is Wake Forest baseball coach Tom Walter.

"On Monday, Walter donated one of his healthy kidneys to Kevin Jordan, a Wake Forest freshman outfielder talented enough to be drafted in the 19th round by the New York Yankees last year but sick enough to wonder if he would ever play again.

"Surviving became Jordan's challenge.

"Today, Walter and Jordan are recuperating together at Emory University in Atlanta, each with one healthy kidney and baseball in their futures.

"I wanted to help this young man," Walter, 42, said on a conference call last week. "When we recruit our guys, we talk about family and making sacrifices for one another. It's something we take very seriously."

"When no one in Jordan's family could give him what he needed, the baseball coach - for whom Jordan has never played a game - did."

Note that there's even an unraveling aspect to the story: the young man was drafted by the Yankees as a high school student.

HT: Thayer Morrill

Tuesday, February 8, 2011

Misc. organ donation stories

Here's a live donor kidney site run a bit in the style of a traditional matchmaker (שַׁדְּכָן‎) by an orthodox Jewish woman who donated a kidney: KidneyMatchmaker.com

But there remain religious objections to deceased donations in Israel, despite rulings in favor by senior rabbis, Haaretz reports: Despite donor card, soccer star Avi Cohen's family keeps hospital from taking organs after lobbying by rabbis
"The family of soccer star Avi Cohen has refused to donate his organs despite the fact that he signed a donor's card - something that has happened only once before in Israel's history.

"Cohen, 54, was declared brain dead Tuesday afternoon at Ichilov Hospital in Tel Aviv, where he had been in critical condition since suffering a motorcycle accident on December 20. The determination was made by a medical committee as required by law.

"Pursuant to Health Ministry regulations, Ichilov then asked his family for permission to use his organs. The family initially agreed, since he had signed the donor's card. But shortly before they were to sign the necessary forms, hospital staffers said, they were contacted by rabbis, some of whom even came to the hospital, and the rabbis dissuaded them.

"Though the Chief Rabbinate was involved in drafting the law on determining brain death that passed two years ago, some rabbis still do not recognize brain death, holding that death occurs only when the heart stops - at which point, most organs become useless.

"The hospital sources said that Sephardi Chief Rabbi Shlomo Amar personally called the family to urge them to approve the donation. But they ultimately sided instead with the rabbis who urged them to leave Cohen intact until his heart stopped, which happened yesterday morning.

"It was Amar - with approval from the Sephardi community's leading halakhic arbiter, Rabbi Ovadia Yosef - who issued the halakhic ruling that held brain death, rather than heart stoppage, to be the true moment of death, and enabled the brain death law to pass.

"Some 600,000 Israelis have signed donor's cards, but the cards have no legal force: When a signatory dies, family permission is still needed to donate organs. Still, the only previous case in which a signatory's family refused occurred over a decade ago."

A NY Times story deals with the question of why NY has relatively few organ donors

"For some, it’s a simple choice: when they die, they would like their organs to be used to save someone else’s life. But New York State doesn’t make it easy. People can sign up when they renew their drivers’ licenses, though that’s only once a decade, or they can go online and fill out an off-putting form, then print it out and walk it to a mailbox.

"A mailbox?

"The New York Organ Donor Network has decided it’s not even worth rolling out its new education campaign until the state makes it easier for people to sign up. People on the waiting list, meanwhile, keep dying. "

And it's not just in New York: Vatican Says Benedict No Longer an Organ Donor
"The Vatican says Pope Benedict XVI, who has long championed organ transplants, is no longer an organ donor.

"The pope's secretary Monsignor Georg Gaenswein addressed the issue in a letter to a German doctor who has been using the fact that Benedict possessed a donor card to recruit other donors.
"Vatican Radio, in a German language report this week, said Gaenswein wrote that while the former Cardinal Joseph Ratzinger's organ card dates to the 1970s it was rendered void when he became pope."

Monday, February 7, 2011

Through the looking glass of medical ethics: compatible pairs in kidney exchange

Some time ago my colleagues and I observed that there would be really large gains in terms of increased numbers of transplants from inviting compatible pairs into kidney exchange, largely because it would increase the supply of O donors.

(see Roth, Alvin E., Tayfun Sonmezand M.Utku Unver A Kidney Exchange Clearinghouse in New England American Economic Review, Papers and Proceedings, 95,2, May, 2005, 376-380.

As with many discussions of organ transplantation, discussions of efficiency are interspersed with discussions of ethics, and almost no good deed goes unquestioned (recall the story of the kidney doc who donated a kidney to a patient*). The current issue of Transplantation has a comment that takes issue with some of the prior discussion of ethics.

Compatible-Incompatible Live Donor Kidney Exchanges, by David Steinberg,Transplantation, 91(3):257-260, February 15, 2011.

Abstract: "The participation of an immunologically compatible donor-intended recipient pair in a kidney exchange that is unnecessary for them can significantly increase the number of kidneys available for transplantation. Despite their utilitarian value transplant ethicists have condemned this type of organ exchange as morally inappropriate. An opposing analysis concludes that these exchanges are examples of moral excellence that should be encouraged."

*Doctor's unique donation prompts ethical concerns: A Chicago-area nephrologist's gift of a kidney to her patient raises the question of whether doctors should be living organ donors.

Sunday, February 6, 2011

Nonsimultaneous kidney exchange chains produce more transplants than simultaneous chains

That's the conclusion of a new paper,
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, forthcoming, 2011.

The "revisited" in the title comes from the fact that the reverse conclusion was reached by an earlier paper in the same journal, due to a modeling error that unnecessarily constrained the length of non-simultaneous chains to be the same as simultaneous chains. (In practice, one of the main attractions of non-simultaneous chains is that they can be longer than chains in which all surgeries are performed simultaneously, since it is no longer necessary to have a different surgical team and operating room for each surgery.)

Here's the abstract of the paper:
"Since 2008 kidney exchange in America has grown in part from the incorporation of non-directed donors in transplant chains rather than simple exchanges. It is controversial whether these chains should be performed simultaneously (“domino paired donation”, DPD) or nonsimultaneously (“nonsimultaneous extended altruistic donor chains”, NEAD). NEAD chains create “bridge donors” whose incompatible recipients receive kidneys before the bridge donor donates, and so risk reneging by bridge donors, but offer the opportunity to create more transplants by overcoming logistical barriers inherent in simultaneous chains. Gentry et al. simulated whether DPD or NEAD chains would produce more transplants when chain segment length was limited to three transplants, and reported that DPD performed at least as well as NEAD chains. As this contrasts with the experience of several groups involved in kidney paired donation, we performed simulations that allowed for longer chain segments and used actual patient data from the Alliance for Paired Donation. When chain segments of 4-6 are allowed in the simulations, NEAD chains produce more transplants than DPD. Our simulations showed not only more transplants as chain length increased, but also that NEAD chains produced more transplants for highly sensitized and blood type O recipients."

One of the most exciting recent events in kidney exchange has been the revolution in using chains of transplants, inaugurated by Mike Rees and the Alliance for Paired Donation, which has really taken off since the publication in 2009 of the account of his first non-simultaneous extended altruistic donor (NEAD) chain:
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

The new paper helps explain why this new kidney exchange technology has caught on so quickly.

Market Design

Friday, February 11, 2011

Experiments in Industrial Organization

Research highlights

Thursday, February 10, 2011

Experimental conference and summer school at Barcelona in June

Wednesday, February 9, 2011

Wake Forest coach donates a kidney to player

Tuesday, February 8, 2011

Misc. organ donation stories

Monday, February 7, 2011

Through the looking glass of medical ethics: compatible pairs in kidney exchange

Sunday, February 6, 2011

Nonsimultaneous kidney exchange chains produce more transplants than simultaneous chains

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Market Design

Friday, February 11, 2011

Experiments in Industrial Organization

Research highlights

Thursday, February 10, 2011

Experimental conference and summer school at Barcelona in June

Wednesday, February 9, 2011

Wake Forest coach donates a kidney to player

Tuesday, February 8, 2011

Misc. organ donation stories

Monday, February 7, 2011

Through the looking glass of medical ethics: compatible pairs in kidney exchange

Sunday, February 6, 2011

Nonsimultaneous kidney exchange chains produce more transplants than simultaneous chains

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