Alex Teytelboym comments throughout a program about market design on NPR's Planet Money:
The episode focuses on the design of markets regulated by governments, and touch on the regulation of fisheries, and on the spectrum incentive auction (about which they interviewed Glen Weyl instead of Paul Milgrom).
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Earlier related posts:
Here's an article pointing out that "slow codes" often constitute resuscitation theater, i.e. they are a way to follow bureaucratic directives requiring attempted resuscitation after cardiac arrest in hospitals, when the physicians don't think that would be in the patient's best interest, i.e. when resuscitation would only prolong dying and suffering. I think this should be part of the discussion of the kinds of "covert" medical aid in dying that takes place even in jurisdictions that don't legally authorize physicians to help shorten the dying process.
McLennan S, Bak M, Knochel K. Slow Codes are symptomatic of ethically and legally inappropriate CPR policies. Bioethics. 2025 May;39(4):327-336. doi: 10.1111/bioe.13396.
Abstract: Although cardiopulmonary resuscitation (CPR) was initially used very selectively at the discretion of clinicians, the use of CPR rapidly expanded to the point that it was required to be performed on all patients having in‐hospital cardiac arrests, regardless of the underlying condition. This created problems with CPR being clearly inadvisable for many patients. Do Not Resuscitate (DNR) orders emerged as a means of providing a transparent process for making decisions in advance regarding resuscitation, initially by patients and later also by clinicians. Under hospital policies in many countries, however, CPR remains the default position for all patients having cardiac arrest in the hospital if there is no DNR order in place, regardless of whether CPR is medically indicated or in the patient's best interests. “Slow Codes” are the delayed or token efforts to provide CPR when clinicians feel CPR is futile or inappropriate. After giving a historical overview of the development and the changing use of CPR, we argue that more attention needs to be given to the cause of slow codes, namely, policies requiring CPR to be performed as the default action while simultaneously lacking implementing interventions such as advance care planning as a routine policy. This is ethically and legally inappropriate, and hospital policies should be modified to allow clinicians to consider whether CPR is appropriate at the time of arrest. Such a change requires a stronger emphasis on early recognition of patients for whom CPR is not in their best interests and to improve hospital emergency planning.
" Proponents of the ‘slow code’ find that intentionally delaying CPR might, in some cases, be a more compassionate alternative to aggressive and potentially futile interventions.
...
"Cardiopulmonary resuscitation is indicated for the patient who, at the time of cardiopulmonary arrest, is not in the terminal stage of an incurable disease. Resuscitative measures on terminal patients will, at best, return them to the dying state. The physician should concentrate on resuscitating patients who were in good health preceding the arrest, and who are likely to resume a normal existence"
As online job ads make it easier to submit chatbot-assisted applications, companies are becoming overwhelmed.
The WSJ has this story:
How to Navigate the Jungle of Online Job Postings
Companies are rethinking online job applications, seeking quality over quantity By Callum Borchers
"You probably haven’t looked for a job in a newspaper’s classified pages since the Bush administration—possibly the first one. It could be worth reviving this old-school strategy because many of the listings offer a way to bypass those dreaded online application portals.
...
"Companies fed up with the low-quality, sometimes fraudulent submissions that flood applicant-tracking systems are reaching back in time for hard-to-hack recruiting methods. Classified ads are just one tack.
"Others include: leaning harder on references; making application forms so cumbersome that only serious candidates will complete them; and posting openings on niche job boards instead of the most popular ones."
Zoos are complicated.
Here's the story from NPR:
A zoo in Denmark asked patrons to donate their pets. Not as attractions, but for food By Alana Wise
"In a post on Facebook, the Aalborg Zoo in Denmark asked people to donate unwanted pets that would be "gently euthanized" and fed to predators in captivity.
...
"The zoo also accepts horses as part of its fodder program.
"The Facebook post quickly became a battleground between commenters who were appalled at the concept of euthanizing healthy pets for animal feed, and those who applauded the zoo for its method of maintaining a practical food supply for its animals.
...
"The Aalborg Zoo says dogs and cats are excluded from the program. Donatable animals are limited to chickens, rabbits, guinea pigs, and horses, it says, adding that this is a practice it has maintained with patrons for years.
"When keeping carnivores, it is necessary to provide them with meat, preferably with fur, bones, etc., to give them as natural a diet as possible," zoo Deputy Director Pia Nielsen said in a statement to NPR.
"Therefore, it makes sense to allow animals that need to be euthanized for various reasons to be of use in this way. In Denmark, this practice is common, and many of our guests and partners appreciate the opportunity to contribute," Nielsen added."
Public art is one of those things that depends in different ways on public and political support.
So, in Denmark, one statue of a mermaid is being removed, while in the U.S. statues of Confederate soldiers are being restored.
The Guardian has the story about the mermaid statue (which isn't _the_ famous little mermaid, but a bigger one):
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USA Today has the story about a statue being restored in Washington D.C.
No one was sad to see this Confederate statue go. Now Trump is bringing it back. | Opinion
Trump wants us to move backward, to a time when our nation's ugly, racist past was swept under the rug. Why else would he be propping up inept Confederate generals while targeting Black history? by Sara Pequeño
"President Trump is advocating for the restoration of a monument honoring Confederate Gen. Albert Pike.
...
Pike, a Freemason and member of the anti-immigrant Know-Nothing Party, was a Confederate general who served for less than two years before resigning. His troops were accused of scalping Union soldiers. There are claims that he was a leader in the Ku Klux Klan after the Civil War, but historians say this can’t be proven."
David K. Levine is celebrated:
Introduction to the Special Issue in Honor of David K. Levine by César Martinelli , Economic Theory. 09 August 2025
"Among contemporary economic theorists, few have made substantial contributions across as many diverse research areas as David K. Levine. His publications hold significant influence among game theorists, general-equilibrium theorists, macroeconomists, political economists, experimental economists, and law-and-economics scholars.
...
"At UCLA, WUSL, EUI, and currently RHUL, he has directed sixty PhD dissertations, and counting. "
The WSJ has the story:
"Want to know what guilty pleasures are gaining and losing popularity in America? Take a look at the stock prices of Molson Coors and Altria .
Marlboro cigarette-maker Altria, which also owns the growing on! nicotine pouch, is up more than 21% so far this year. Shares of Molson Coors, the brewer behind beer brands such as Miller Lite and Blue Moon, are down more than 13%.
Companies that traditionally sold cigarettes are seeing new engines of growth, no tobacco or smoking required. Nicotine pouches like on! and British American Tobacco’s BATS 0.93%increase; green up pointing triangle Velo look like tiny tea bags that sit between the gum and the cheek and are often filled with wood pulp along with nicotine salts and flavorings. The nicotine is absorbed into the bloodstream through the mouth’s lining.
Zyn, which is produced by Swedish Match North America, an affiliate of Philip Morris International PM 1.30%increase; green up pointing triangle, is the most popular nicotine pouch. It gained popularity due in part to a devoted following of unaffiliated “Zynfluencers” who tout their love of the brand.
Earlier this year, U.S. health officials authorized Zyn to stay on the market after finding that it has benefits as an alternative for adult smokers that outweigh its potential risk to young people."
Here's a recent estimate of lives saved by Covid vaccines.
Ioannidis JPA, Pezzullo AM, Cristiano A, Boccia S. Global Estimates of Lives and Life-Years Saved by COVID-19 Vaccination During 2020-2024. JAMA Health Forum. 2025;6(7):e252223. doi:10.1001/jamahealthforum.2025.2223
"Question What was the global impact of COVID-19 vaccinations on deaths during the 2020-2024 period?
Findings This comparative effectiveness study found that COVID-19 vaccinations averted 2.5 million deaths during 2020-2024 (sensitivity range estimates, 1.4-4.0 million) and saved 15 million life-years (sensitivity range estimates, 7-24 million life-years). The estimated benefits had a steep age gradient.
Meaning COVID-19 vaccinations had a substantial benefit on global mortality during 2020-2024, but this benefit was mostly limited to a minority of the population of older individuals."
Last week I had the opportunity to see a screening of the movie Abundant, about non-directed organ donors, who have donated organs to strangers. Here is a snapshot of me and two of the donors who tell their story in the film, Laurie Lee and Laura Diaz Moore. They are both pretty inspiring.
Here's a great new book about how to navigate markets, by Judd Kessler, who knows his way around.
Lucky by Design: The Hidden Economics You Need to Get More of What You Want– forthcoming, October 14, 2025 by Judd Kessler
"What’s the secret to scoring a reservation at a hot new restaurant? When should you enter a lottery to increase your odds of winning? Why did your neighbor’s kid get into a nearby preschool while yours didn’t? Who gets priority for a life-saving organ donation?
These outcomes are not a matter of luck. Instead, they depend on how we navigate hidden markets that arise to decide who gets what when many of us want something and there isn’t enough to go around. Every day we play in these markets, yet few of us fully understand how they work.
In familiar markets, what we get depends on how much we’re willing to pay. Hidden markets do not rely on prices: you can’t buy your way in to a better position. Instead, what you receive hinges on the rules by which the market operates, and the choices you make in them.
Judd Kessler has spent a career studying and designing these very markets. Now, he reveals the secrets of how they work, and how to maneuver in them. Whether you want to snag a coveted ticket, secure a spot in an oversubscribed college course, get better matches in the dating and job markets, do your fair share of the household chores (but no more), or more efficiently allocate your time and attention, this must-read guide will show you how to get Lucky by Design."
#####
Market design advice: pre-order now to be the first on your block, and to help the book.
Dr. Vivek Kute is the transplant nephrologist at one of the most active single-center kidney exchange programs in the world. When he spoke on Thursday at Stanford's conference on extending kidney exchange, he used the slide below to help illustrate how India's move to multi-hospital kidney exchange (also called kidney paired donation, KDP) would change the opportunities to find compatible living donor kidney transplants (LDKT)...
Here's a photo from his post-conference tweet:
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I've often blogged about Dr Kute's work.
The NYT is standing by its recent stories on deceased organ donation. In the meantime Newsweek has this story about people who have had second thoughts about deceased donation. (For the record, while it's very important to scrutinize current practices, none of the reported concerns even made me think about withdrawing from the donor registry.)
Mass Exodus From Organ Donor Registries Following Media Coverage by Joshua Rhett Miller
"Thousands of Americans have removed themselves from organ donor registries following "irresponsible reporting" led by the New York Times, officials said.
The Association of Organ Procurement Organizations, a trade group that represents 46 of the nation's 55 federally designated nonprofit entities that help facilitate donations, accused the newspaper of a "lack of balance and accuracy" in its recent coverage of the problems in the sprawling transplant system.
The letter, sent to three Times editors on Tuesday, cited two articles from July 20, including "A Push for More Organ Transplants Is Putting Donors at Risk," in which reporters Brian M. Rosenthal and Julie Tate detailed rushed or premature attempts to retrieve organs from patients who were, in some cases, still showing signs of life.
A third recent Times item, an op-ed written by three cardiologists in which they argue for a "new definition of death" to help alleviate the backlog of recipients in need of transplants, was not included in the letter. The essay has gone viral on X, with many users commenting it has made them rethink or actively change their status as organ donors.
...
"AOPO claims both articles contained "serious factual inaccuracies," including the trade group attributing "any errors to hospitals" in the story written by Rosenthal and Tate. That phrase wasn't a part of AOPO's response to the newspaper, which subsequently updated the article, according to Tuesday's letter.
"The main article from July 20 also omitted or misrepresented key facts in some donation cases," the letter continued. "The absence of critical context in the story has fueled massive mistrust in the donation process."
...
"This is the largest spike in registry removals ever recorded in the history of organ donation in the U.S.," AOPO letter reads. "The New York Times' coverage — coupled with a wave of secondary stories by other outlets and widespread, sensationalistic commentary and online reactions — has initiated a wave of panic and fear across the United States."
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Earlier:
Rosemarie Nagel and Miklos Pinter have sent me the following story about how Miklos helped design the game-theoretic image on the Hungarian coin issued in memory of John Harsanyi's 100th birthday.
"The Harsanyi coin told by Miklos Pinter
The MNB (National Bank of Hungary) has a series of coins dedicated to famous Hungarians (see: MNB Collector Coins), including von Neumann, George Oláh, Imre Kertész, György Cziffra, among others.
In the summer of 2019, I was invited by the MNB to join a board responsible for planning a collector coin honoring János Harsányi on the centenary of his birth (1920). The MNB found me through one of my (former) colleagues, recognizing me as an expert on Harsányi’s contributions that led to his Nobel Prize.
I served as the scientific expert on the board. The other members included artists, coin production experts, and MNB officials. My role was to ensure the scientific "message" of the coin was accurate and meaningful. The coin designs follow a structure: one side features a portrait of the person (which was not my area), while the other side presents a motif, symbol, or image representing their scientific contribution—that side was my responsibility.
To start, I gave a talk to the participating artists (sculptors) who were preparing to submit designs. My presentation covered essential background on Harsányi and, more importantly, the main contribution that earned him the Nobel Prize: the concept of type space. With one exception, all invited artists attended. The atmosphere was pleasant; we had good discussions during and after the talk. It was informal, and I felt satisfied with how it went—it seemed the artists appreciated it too.
A few months later, the artists submitted their sketches—four or five proposals, each with a portrait on one side and a motif on the other.
Here came the surprise: the artists had clearly ignored my talk. Instead, they googled “game theory,” found images online, and based their designs on those. The proposed motifs included things like matrix games and extensive form games, which are only loosely related to Harsányi’s work. Crucially, none of the proposals reflected his key contribution involving type spaces. In hindsight, I realized this was partly my fault. In my talk, I used no visual tools—no images or illustrations—which was a mistake. Artists think visually, and my purely verbal presentation, though scientifically accurate, was practically useless for their purposes.
The board evaluated the proposals. The portraits were excellent, and the artists on the board selected the best one—it was truly beautiful, and I fully agreed, even though it wasn't my area of expertise.
The motif side, however, was a different story. I judged all the proposed designs as inadequate. They were either unrelated to Harsányi or depicted concepts associated with other scientists. I therefore recommended rejecting all of them.
The board accepted my recommendation but raised concerns: time was tight (this was already September 2019, and the coin had to be issued by May 2020), and it was unclear whether the artists could come up with a new, meaningful design in time.
Some board members informally emailed me, asking what could be done. I replied that the proposed motifs weren’t acceptable, but I shared an idea: Imagine a staircase—either rectangular or triangular—that rises or descends infinitely. In the middle of this staircase, there is a ladder stretching directly from the starting point to infinity.
They responded immediately and liked the idea. I hadn’t drawn anything—just described it in a few sentences. Later, we had a phone call, and I explained that the staircase represents a belief hierarchy, while the ladder represents a type—two different ways to reach the same end. This, essentially, is Harsányi’s insight.
They appreciated the concept even more after that conversation. The board then narrowed the selection to two artists and asked them to create a design for the motif side based on my description.
By December 2019, I received the revised designs, particularly one that I really liked. You can see it as the final version of the coin here: 👉 Harsányi Collector Coin – MNB
#####
Collector coin issuance on the centenary of Nobel Memorial Prize winner János Harsányi’s birth
"The Magyar Nemzeti Bank [issued] a silver collector coin with a face value of 10,000 forints and its non-ferrous metal version of 2,000 forints, on the 100th anniversary of János Harsányi’s birth, the Nobel Memorial Prize in Economics awarded scientist, on 29 May 2020. By issuing this collector coin, the MNB wishes to pay tribute to the renowned researcher of the game theory, who was a co-recipient of the 1994 Nobel Memorial Prize in Economic Sciences along with two other scientists, John Forbes Nash and Reinhald Selten ‘For his ground-breaking work in the area of non-cooperative game theory and equilibrium analysis'. The collector coins were designed by sculptor Balázs Pelcz.
"János Harsányi, a Hungarian Nobel Memorial Prize laureate in Economic Sciences, was born in Budapest on 29 May 1920. His primary field of research was game theory, he was awarded the Nobel Memorial Prize in Economic Sciences for the results he achieved in incomplete information games in 1994 as a co-recipient with John Forbes Nash and Reinhard Selten ‘For his ground-breaking work in the area of non-cooperative game theory and equilibrium analysis'. In the field of game theory, they were the first scientists to receive the Nobel Memorial Prize in Economic Sciences.
We'll be welcoming many of our transplantation colleagues to a conference at Stanford today.
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Earlier:
Here's a recent paper from PNAS, analyzing the organized activity of paper mills producing fraudulent papers.
The entities enabling scientific fraud at scale are large, resilient, and growing rapidly by Reese A. K. Richardson, Jennifer A. Byrne, and Luís A. Nunes Amaral
Edited by Daniel Acuña, University of Colorado Boulder, accepted by Editorial Board Member Mark Granovetter August 4, 2025 https://doi.org/10.1073/pnas.242009212
Abstract
Science is characterized by collaboration and cooperation, but also by uncertainty, competition, and inequality. While there has always been some concern that these pressures may compel some to defect from the scientific research ethos—i.e., fail to make genuine contributions to the production of knowledge or to the training of an expert workforce—the focus has largely been on the actions of lone individuals. Recently, however, reports of coordinated scientific fraud activities have increased. Some suggest that the ease of communication provided by the internet and open-access publishing have created the conditions for the emergence of entities—paper mills (i.e., sellers of mass-produced low quality and fabricated research), brokers (i.e., conduits between producers and publishers of fraudulent research), predatory journals, who do not conduct any quality controls on submissions—that facilitate systematic scientific fraud. Here, we demonstrate through case studies that i) individuals have cooperated to publish papers that were eventually retracted in a number of journals, ii) brokers have enabled publication in targeted journals at scale, and iii), within a field of science, not all subfields are equally targeted for scientific fraud. Our results reveal some of the strategies that enable the entities promoting scientific fraud to evade interventions. Our final analysis suggests that this ability to evade interventions is enabling the number of fraudulent publications to grow at a rate far outpacing that of legitimate science.
#########
And here's the story in the NYT:
Scott Kominers is interviewed about crypto art, by Lorepunk:
How Harvard Professor Scott Kominers Makes PFP Puzzles Out Of Math
Lorepunk
"The meaning of art lies in more than just beauty, and the meaning of math resides in more than the work it can do in our technologies and lives. Both reflect, and describe, the reality of our existence.
"That’s what drew this writer to the art of Scott Kominers, who is what they used to call “a man of parts,” accomplished in many fields. He’s a professor at Harvard Business School, a research partner at the crypto arm of venture capital firm a16z, and a designer of market incentives. We in the web3 space also know him as a great commentator and champion of NFTs, who penned “The Everything Token” alongside Steve Kaczynski.
"His art collections, first launched in January 2025, bring these threads together, weaving playful math references and cultural connections into bold, colourful fields of pixels, generative and fully on-chain.
"They are appealing to the eye, but what inspires most about Kominers’ artworks is that they have their own vernacular, or artistic language.
"NFT collectors know about these. Opepen is one, Punks another. You can express or reference many things with an artistic grammar: check out, for example, this version of the Magna Carta, the document that established the principle that nobody is above the law. Kominers’ version dropped on June 14, the day that Trump watched a tepid military parade on his birthday.
...
"Lorepunk: For those who might be new to your body of artistic work: how did you develop with your unique style – fields of pixels, often referencing cultural phenomena within our community via colour and pattern, math-forward, with puzzles attached?
Scott Kominers: 2025 is a perfect square, i.e., 45². I’ve always loved celebrating unusual properties of numbers – and, on New Year’s Day I realized that this means that the year can be expressed as a perfectly square 45 x 45 pixel canvas."
...and more...
From the Free Press, tasting notes on a variety of performance enhancing drugs for concentration, finally converging on what sounds like nicotine addiction.
I Tried Wall Street’s Famous Brain Drugs
My experimental high and crash through the not-quite-legal, sort of effective, occasionally heart-pounding medicine cabinet of Wall Street and Silicon Valley’s productivity optimizers. by Park MacDougald
"Vyvanse:
The brand name for lisdexamfetamine, a prodrug that, once ingested, slowly converts to dextroamphetamine, one of the active ingredients in Adderall. Originally developed as a longer acting and less easily abused alternative to dextroamphetamine, lisdexamfetamine is now the third most commonly prescribed stimulant in the United States, according to the Drug Enforcement Agency (DEA), with around 15 million prescriptions dispensed in 2023. With insurance, a 30-day supply of Vyvanse can run around $60.
...
" Strattera: Generic name atomoxetine, Strattera is a selective norepinephrine reuptake inhibitor initially developed by Eli Lilly to treat depression, but later approved by the Food and Drug Administration (FDA) as an ADHD treatment when it was found to be ineffective for its intended use. Strattera is far less commonly prescribed than Adderall, Vyvanse, or Ritalin—4.3 million prescriptions were dispensed in 2023, per the DEA—but may be favored for patients with a history of addiction, due to its low potential for abuse. It’s also cheap; with my insurance, a month’s supply of Strattera cost less than $10.
...
"Dextroamphetamine: Basically like Adderall but without levoamphetamine, a less potent amphetamine isomer that helps to smooth the overall effects of the drug. Dextroamphetamine, or “dexy,” has been available since the 1930s, and was issued to U.S. bomber pilots in World War II to help keep them awake on nighttime missions. It’s still around today, but far less common than Adderall or Ritalin (methylphenidate). Around 915,000 dextroamphetamine prescriptions were dispensed in the United States in 2023, according to the DEA.
...
"Modafinil: Unlike the other drugs on this list, Modafinil is not primarily an ADHD treatment. It’s a non-amphetamine stimulant and “wakefulness-promoting agent” developed in France during the 1970s and 1980s as a treatment for narcolepsy, but its current claim to fame is for its use by the U.S. Air Force to manage pilot fatigue on long missions (it’s also frequently prescribed for night-shift workers). Prescription modafinil is generally cheap with insurance, but the variant I bought—a supplement containing adrafinil, a closely related substance—cost $40 for a jar of 30 pills.
...
"Zyn: Zyn is the original brand of smokeless tobacco pouches, introduced by a Swedish company, Swedish Match, as a tobacco-free alternative to Snus in 2014 (its major competitor, Velo, is also Swedish, though both companies are now owned by international tobacco conglomerates). In the United States, Zyn is sold in tins of 3 mg or 6 mg pouches, though the European version of the product—which I purchase from my local Yemeni-owned bodega in New York City—also comes in 9 mg, 11 mg, and 13.5 mg varieties. Retail, in New York, a tin costs around $9—up from $5–$6 only a few years ago.
...
"For me, however, 6 mg of Zyn—rising to 9 mg in times of crisis—has become a necessity akin to drinking water. I no longer know what Zyn “feels like,” per se, since I only feel its absence, in the form of scattered attention, forgetfulness, and low-level irritability. When I am on deadline or otherwise swamped with work, I rarely go 10 minutes without a pouch in my mouth."
It has long been the conventional wisdom in transplantation that xenotransplants--transplanting a kidney from a genetically modified pig into a human--will be tomorrow's cure for kidney failure, and always will be.
But lately there are some causes for optimism that the timeline may be quicker than that.
Here's a recent review of the evidence:
Xenotransplantation in Humans: A Reality Check, by A. Joseph Tector, MD, PhD
Transplantation 109(2):p 231-234, February 2025. | DOI: 10.1097/TP.0000000000005223
"Thirty years after the initial strategies to develop genetically engineered pigs for use as organ donors in xenotransplantation were described, evaluation of these pig organs in humans has begun.1 The initial experience includes decedent experiments in kidneys and hearts, as well as 5 clinical cases (2 hearts, 2 kidneys, and 1 auxiliary liver). The cardiac xenograft survival was 47 and 40 d, whereas patient survival was 60 and 40 d.2-4 In the initial kidney xenografts, patient survival was 52 d for the first kidney, and the second kidney was removed at 47 d with the patient still alive in the intensive care unit. The initial results in the decedent work as well as the clinical cases indicate that the initial barrier of hyperacute rejection (HAR) has been averted with genetic engineering, but that much work remains before we can begin to offer xenotransplantation as a routine therapy for the treatment of end-stage organ failure. Evaluation of the renal xenografts in decedents and the 2 cardiac xenografts make it clear that although HAR is no longer an issue the problem of antibody-mediated rejection (AMR) secondary to xenoantigens on the pig cell remains.5,6 Moving forward, 4 key areas that must be addressed to realize the goals of bringing xenotransplantation to clinical practice are (1) patient selection, (2) donor pig genetics, (3) immunosuppression issues, and (4) animal husbandry challenges."
Here's the paper's final sentence:
"The human experience suggests that clinical xenotransplantation will
work sooner rather than later, but there is still some heavy lifting in
front of us that will require continued careful detailed laboratory
investigation guided by the feedback from preclinical evaluation."
Nicotine remains a big source of addiction, and (especially in connection with cigarette smoking) a major cause of premature death. Here's a brief report on the Whac-A-Mole nature of efforts to limit addiction, particularly by minors.
Vaping Declined in States With Flavor Bans -- But It's Not All Good News— Restrictions were also tied to increased cigarette use in youths and young adults
by Shannon Firth, MedPage Today July 31, 2025
Here's a recent article about patients waiting for a deceased-donor organ transplant in the U.S. who (instead) received one overseas (and so removed themselves from the U.S. deceased-donor waiting list, from 2010 to 2023. In that period, the total number of deceased donor transplants in the US rose from about 20,000 per year to about 40,000 per year. Around 60 patients a year are removed from the waitlist for this reason, i.e. on the order of one tenth of one percent.
The tone of the paper is captured by the statement that this is "not universally unethical".
Landscape of US Waitlist Registrants who Received Transplantation Abroad
Terlizzi, Kelly MS1; Jaffe, Ian S. MD, MSc1; Bisen, Shivani S. MD1; Lonze, Bonnie E. MD, PhD1; Orandi, Babak J. MD, PhD1,2; Levan, Macey L. JD, PhD1; Segev, Dorry L. MD, PhD1; Massie, Allan B. PhD Transplantation ():10.1097/TP.0000000000005467, July 14, 2025.
Abstract:
"Background.
Transplant waitlist registrants in the United States may be delisted because of receipt of a transplant abroad. Although not universally unethical, “travel for transplantation” poses risks to posttransplant care. To better understand this phenomenon, this study identifies temporal trends, geographic patterns, and demographic factors associated with cross-border transplantation.
Methods.
Using Scientific Registry of Transplant Recipients data, we identified 818 US waitlist candidates who were removed because of transplantation abroad between 2010 and 2023. We described recipient characteristics overall, by organ, and by top transplant destinations. We used a Cox regression framework to identify characteristics associated with waitlist removal due to transplantation abroad.
Results.
Transplants abroad averaged 58.4 per year. Incidence peaked at 80 transplants in 2017, with an upward trend after 2021. Kidney transplants made up 92.1% of cases. The most common destinations were the Philippines (19.8%), India (16.5%), Mexico (9.4%), China (8.4%), and Iran (4.4%). India and Mexico experienced the smallest drop-off during the height of the COVID-19 pandemic 2020–2021. Most recipients were US citizens (65.0%) or residents (23.5%). Female (adjusted hazard ratio [aHR], 0.520.610.71; P < 0.001) and Black candidates (aHR, 0.120.180.26; P < 0.001) were less likely to travel abroad compared with Asian candidates (aHR, 5.927.108.52; P < 0.001). Nonresidents (aHR, 6.708.6911.26; P < 0.001) and, among registrations in 2012 or later, nonresidents who traveled to the United States for transplantation (aHR, 27.2738.9155.50; P < 0.001) had a greater chance of undergoing transplantation abroad.
Conclusions.
Understanding patterns of international travel for transplantation is key not only for preventing resource drains from destination countries but also for providing adequate posttransplant care for recipients."
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