Showing posts sorted by relevance for query kidney AND Alabama. Sort by date Show all posts
Showing posts sorted by relevance for query kidney AND Alabama. Sort by date Show all posts

Tuesday, January 13, 2015

A long non-simultaneous kidney exchange chain in Alabama

From the University of Alabama at Birmingham:

Nation’s Longest Kidney Transplant Chain Reaches 34

 "The chain, which began in December 2013, has matched 34 living donors with 34 recipients to create the longest kidney-transplant chain ever recorded in the United States; previously, the longest chain on record involved 30 donors and recipients in 17 hospitals around the country. All 34 recipients in the UAB kidney chain have been transplanted at UAB Hospital or Children’s of Alabama.
...
"Sixty-seven of the 68 surgeries in the chain to date have been performed at UAB Hospital. One recipient, 15-year-old Ryane Burns of Union, Mississippi, was transplanted at Children’s of Alabama, making it the only program in the Southeast to offer living-kidney paired donation to recipients younger than 18.
...
"more transplants are planned in January 2015. Denise Prewitt is a bridge donor who is expected to be part of the chain in the New Year. She is donating on behalf of Marjorie Wilhite who received her kidney this past summer."

Thursday, May 25, 2017

Supporting science during the budget process--an op-ed in Alabama

Government funding of science is important, and at risk.  Here's an opinion piece that ran yesterday in Alabama, which seeks to bring some of the direct benefits in Alabama to the attention of Alabama's citizens and representatives in Washington (using the active kidney exchange program in Alabama as an example).

Trump budget puts future scientific advances at risk
By Alvin E. Roth, the Craig and Susan McCaw Professor of Economics at Stanford University
and Dr. Jayme Locke, Associate Professor at UAB School of Medicine and the Director of the Incompatible Kidney Transplant Program and Transplant Analytics, Informatics & Quality

Here are the final paragraphs:

"As the Director of the Incompatible Kidney Transplant Program at UAB and a Nobel Prize winning economic researcher, we have seen first-hand the power of science to connect those suffering with disease with vital cures.

We applaud Senator Shelby as a leader of the Senate Appropriations Committee, and Representatives Aderholt and Roby on the House Appropriations Committee, as well as all of the Alabama Congressional delegation on their work to support vital R&D investments in a bipartisan way.

We are hopeful that leaders will once again demonstrate that funding America's future innovation is a bipartisan imperative. "

Thursday, July 10, 2014

A long kidney chain at U. Alabama Birmingham

A long nonsimultaneous kidney exchange chain, which began in December, is underway at the University of Alabama at Birmingham hospital. Here's an update: Nation’s largest single-site kidney transplant chain, underway at UAB

PRESS RELEASE chain by the numbers"Twenty-one living donors have changed the lives of 21 recipients so far as part of the nation’s longest ongoing single-center paired kidney transplant chain, which is under way at the University of Alabama at Birmingham Hospital. The UAB kidney chain is scheduled to resume with six more transplants the week of July 7."

More information, including an informative video at http://www.uab.edu/kidneychain/

Thursday, June 24, 2021

Health Applications Society Online Seminar Series (Inaugural seminar Friday June 25, on Kidney Exchange)

A new seminar series is being organized by the Health Applications Society of INFORMS.  I'll be giving the inaugural seminar tomorrow, June 25.

Here's the general announcement:

Health Applications Society Online Seminar Series

"Welcome to the HAS Online Seminar Series! This seminar series welcomes a broad range of healthcare modeling research topics such as healthcare operations, medical decision making, health policy, and health analytics. 

Please join our Google Group or subscribe to our Mailing List to receive the latest announcement on the upcoming seminars!

When: 1-2 pm ET (10-11 am PT) on 4th Friday of each month

Where: Zoom Webinar (Register Now!)   

Speaker: Dr. Alvin E. Roth, Stanford University

Seminar Title: Kidney Exchange: An Operations Perspective

Date and Time: June 25 (Friday), 2021, 1-2 pm ET (10-11 am PT)

Abstract: Many patients in need of a kidney transplant have a willing but incompatible (or poorly matched) living donor. Kidney exchange programs arrange exchanges among such patient-donor pairs, in cycles and chains of exchange, so each patient receives a compatible kidney. Kidney exchange has become a standard form of transplantation in the United States and a few other countries, in large part because of continued attention to the operational details that arose as obstacles were overcome and new obstacles became relevant. We review some of the key operational issues in the design of successful kidney exchange programs. Kidney exchange has yet to reach its full potential, and the paper further describes some open questions that we hope will continue to attract attention from researchers interested in the operational aspects of dynamic exchange.

Bio: Al Roth is the Craig and Susan McCaw Professor of Economics at Stanford, and the George Gund Professor Emeritus of Economics and Business Administration at Harvard. He and Lloyd Shapley shared the 2012 Nobel memorial prize in Economics "for the theory of stable allocations and the practice of market design.”  He received a Ph.D. in Operations Research from Stanford University in 1974.

Seminar Organizers and Advisory Board: This seminar series is organized by Sanjay Mehrotra (Northwestern University)Sait Tunc (Virginia Tech)Qiushi Chen (Pennsylvania State University).

The advisory board includes Ebru Bish (University of Alabama)Stephen Chick (INSEAD), and Mark Van Oyen (University of Michigan).

Special thanks to INFORMS Healthcare Application Society and all board members for their enormous support!"

Sunday, October 2, 2016

Kidney exchange chains (a survey, including possibly the longest chain to date)

Here's a survey on non-simultaneous kidney exchange chains: Are Transplant Chains the Answer to Our Kidney Deficit? by Melissa Laracy

On long chains:
"Currently, the longest living kidney donor chain is the University of Alabama at Birmingham Kidney Chain. Started in December 2013, it has since grown to include 112 individuals, yielding a total of 56 kidney transplants as of December 2015."

See also "Celebrating the nation's longest kidney chain" at UAB

Saturday, August 8, 2015

Is it time to compensate kidney donors?

Tina Rosenberg in the NY Times thinks it is: It’s Time to Compensate Kidney Donors

"Still, a debate is beginning to emerge. In the United States, some prominent kidney doctors believe we might learn something from Iran. “My journey was from ‘this is all immoral and we shouldn’t think about it’ to the other side,” said Robert Gaston, executive co-director of the Comprehensive Transplant Institute at the University of Alabama at Birmingham, and a recent past president of the American Society of Transplantation, one of two American organizations of transplant doctors. “Iran’s program can’t be termed a universal success. But it is a reasonable approach, a transparent, ethical way to address kidney disease in the population there.”

While no country seems willing to follow Iran into providing monetary incentives for kidney donors, many are starting to remove the financial disincentives that make donating a kidney an activity only for those with disposable income."

Sunday, November 5, 2023

Deceased organ donation in the Economist (article and letter to the editor)

 Here's a recent article on deceased organ donation, in The Economist, followed by a letter to the editor from Alex Chan and me.

In America, lots of usable organs go unrecovered or get binned. That is a missed opportunity to save thousands of lives

"More than four-fifths of all donated organs and two-thirds of kidneys come from dead people (who must die in hospital); living donors can give only a kidney or parts of a lung or liver. Whereas some countries, such as England, France and Spain, have an opt-out model, in America donors must register or their families must agree. Persuading them will always be hard: Dr Karp’s hospital gets consent from about half of potential donors.

...

"Responsibility lies partly with some of the 56 nonprofit Organ Procurement Organisations (opos), like LiveOnNY, that do the legwork. Brianna Doby, a researcher and consultant, advised Arkansas’s opo in 2021 and was astounded to learn that most calls about potential donors went unanswered outside the nine-to-five workday and at weekends. Other opos, by contrast, sent staff to hospitals within an hour of an alert about a prospective donor.

...

"Yet unrecovered organs are not the only reason America could do more transplants. A surprising number of organs from deceased donors end up in the rubbish: more than a quarter of kidneys and a tenth of livers last year.

...

"Hospitals are often risk-averse, too. Discard rates are higher for organs of lower quality.

...

"For elderly recipients, getting older or otherwise risky kidneys generally means better odds of survival than staying on dialysis. But hospitals dislike using them for two reasons. First, they can lead to more complications and thus require more resources, eating into margins. Second, if the recipient dies soon after the transplant, hospitals suffer—a key measure used to evaluate them is the survival rate of recipients a year after transplant. According to Robert Cannon, a liver-transplant surgeon at the University of Alabama at Birmingham, hospitals succeed by being excessively cautious and keeping patients with worse prospects off waiting lists."

#########

And here's our followup letter to the editor, published November 2:

Organ-donation economics

"More than 110,000 Americans are waiting for an organ transplant and over 5,000 died waiting for an organ in 2019. Close to 6,000 recovered organs were discarded. “Wasted organs” (September 23rd) correctly pointed out that the responsibility lies in part with non-profit Organ Procurement Organisations and in part with the excessive caution exercised by transplant centres when deciding who to conduct transplants for and which kidneys to use.

"Numerous initiatives in Congress, and more proposed by various non-governmental agencies, such as the Federation of American Scientists and the National Academies of Sciences, Engineering and Medicine, among others, have been focused on tweaking how the performance of organ procurers and transplant centres should be measured while keeping in place the system that put us in today’s quagmire. As we indicate in our recent paper (conditionally accepted at the Journal of Political Economy), such approaches that keep regulations fragmented are bound to be inefficient, given that the incentives and opportunities facing organ procurers and transplant centres are intertwined.

"We show that “holistic regulation”, which aligns the interests of organ procurers and transplant centres by rewarding them based on the health outcomes of the entire patient pool, can get at the root of the problem. This approach also leads to more organ recoveries while increasing the use of organs for sicker patients who otherwise would be left without a transplant.

"In the end increasing access to kidney transplantation will require the improvement of the entire supply chain of organs. This means boosting donor registrations and donor recoveries from the deceased. It also means increasing living donations, and co-ordinating donations through mechanisms like paired kidney donations and deceased-donor-initiated kidney- exchange chains.


Alex Chan, Assistant professor of business administration, Harvard University

Alvin E. Roth, Professor of economics, Stanford University

####

And here's the paper referred to in our letter, on Alex's website:

Regulation of Organ Transplantation and Procurement: A Market Design Lab Experiment, by Alex Chan and Alvin E. Roth

Abstract: "We conduct a lab experiment that shows current rules regulating transplant centers (TCs) and organ procurement organizations (OPOs) create perverse incentives that inefficiently reduce both organ recovery and beneficial transplantations. We model the decision environment with a 2-player multi-round game between an OPO and a TC. In the condition that simulates current rules, OPOs recover only highest-quality kidneys and forgo valuable recovery opportunities, and TCs decline some beneficial transplants and perform some unnecessary transplants. Alternative regulations that reward TCs and OPOs together for health outcomes in their entire patient pool lead to behaviors that increase organ recovery and appropriate transplants."

Thursday, August 4, 2022

UNOS hearing in the Senate

 Yesterday in D.C. ... a tough hearing of the Senate Finance committee.  You can listen to the video now, but it looks like the committee will populate the links to documents only slowly.

[Update: better video link-- 

https://www.youtube.com/watch?v=iA2wuSN7POs ]

A System in Need of Repair: Addressing Organizational Failures of the U.S.’s Organ Procurement and Transplantation Network


Date: Wednesday, August 3, 2022Time: 02:30 PMLocation: 215 Dirksen Senate Office Building

Agenda


Pursuant to guidance from the CDC and OAP, Senate office buildings are not open to the public other than official business visitors and credentialed press at this time. Accordingly, in-person visitors cannot be accommodated at this hearing. We encourage the public to utilize the Committee’s livestream of the hearing, available on the website at https://www.finance.senate.gov/

Member Statements


  1.  Ron Wyden (D - OR)
  2.  Mike Crapo (R - ID)

Witnesses


  1. Brian Shepard
    Chief Executive Officer
    United Network for Organ Sharing (UNOS)
    Richmond , VA
  2. Diane Brockmeier, RN
    President And CEO
    Mid-America Transplant
    St. Louis , MO
  3. Barry Friedman, RN
    Executive Director
    AdventHealth Transplant Institute
    Orlando , FL
  4. Calvin Henry
    Region 3 Patient Affairs Committee Representative
    Organ Procurement and Transplantation Network (OPTN)
    Atlanta , GA
  5. Jayme Locke, M.D., MPH
    Director, Division Of Transplantation, Heersink School Of Medicine,
    University of Alabama at Birmingham
    Birmingham , AL

Related Files


 How do I submit a statement for the record?

Any individual or organization wanting to present their views for inclusion in the hearing record should submit in a Word document, a single-spaced statement, not exceeding 10 pages in length. No other file type will be accepted for inclusion. Title and date of the hearing, and the full name and address of the individual or organization must appear on the first page of the statement. Statements must be received no later than two weeks following the conclusion of the hearing.

Statements can be emailed to:

Statementsfortherecord@finance.senate.gov

Statements should be mailed (not faxed) to:

Senate Committee on Finance
Attn. Editorial and Document Section
Rm. SD-219
Dirksen Senate Office Bldg.
Washington, DC 20510-6200

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

Here's a Washington Post story that came out yesterday, while the hearing was in progress:

70 deaths, many wasted organs are blamed on transplant system errors An investigation by the Senate Finance Committee blamed the fatalities on errors in screening organs for disease, blood-type mix-ups and other mistakes  By Lenny Bernstein and Todd C. Frankel August 3, 2022 at 2:30 p.m. EDT