A decade of progress in kidney exchange in India

 This morning I zoomed in to the tail end of a quiet celebration in India of a decade of collaboration between the Alliance for Paired Kidney Donation  (APKD) and our Indian medical colleagues..

Mike Rees and I both had sent messages of support, and during the call I spoke about my hope that India, which already does the third most kidney transplants in the world, will in the coming decade come to be the country that does the most kidney exchange transplants. That in turn could lead to India eventually becoming a global attractor for patient-donor pairs from countries that don't have lots of transplants or exchanges, to come to India to participate in kidney exchange there.

There remain many obstacles to be overcome before that can happen, but there's been so much progress in India already that those are real possibilities.

Here's the message I emailed to the founding team yesterday:

"Dear Vivek, Pranjal, Mike, Atul  and Colleagues: It’s amazing that the collaboration  between the Institute of Kidney Diseases and Research Center at the Dr. H L Trivedi Institute of Transplantation Sciences, and the Alliance for Paired Donation is entering its second decade.  It’s been thrilling for me to observe the progress that you have made.  I recall vividly meeting Dr. Trivedi in 2019 in his hospital room, and I was later deeply honored to deliver The Dr H.L. Trivedi Oration at the ISOT Meeting  in 2022.  I’ve learned so much from Vivek, and I will never forget watching Pranjal perform a robotic surgery.  And it was memorable that you both were able to visit us at Stanford for the kidney summit organized by APKD and Stanford Impact Labs.
 

"Seeing what you have accomplished has been one of the highlights of my career in market design. It’s good that we’re all still young, since I’m looking forward to the next decade of accomplishment in India." 
 #########

Here's Mike's message:

"Mike Rees on the 10-year anniversary of IKDRC and APKD working together

"I remember the first time I met Vivek in 2016 at the TTS meeting in Hong Kong. Vivek received the “International Transplantation Science Mentee-Mentor” Award at the TTS 2016 Congress in Hong Kong. The award recognized his work on "Impact of Single Center Kidney Paired Donation Transplantation to Increase Donor Pool in India," completed under the mentorship of Prof. H.L. Trivedi and Prof. P.R. Shah. I remember meeting Vivek, Dr. PR Shah and Pranjal at the award ceremony and thinking about how wonderful it would be if we could work together. I imagined harnessing their great passion of helping patients through kidney transplantation and paired exchange and combining that with the APKD’s powerful software employing Al Roth’s Nobel Prize winning algorithm. While in Hong Kong, Vivek and I went to dinner at my first vegetarian restaurant and there we agreed to work together to try to help expand kidney exchange in India. 
 

"Three years later I travelled to Ahmedabad in May of 2019 with Alvin Roth for the ISOT Mid-term meeting. During that trip, Al and I watched Pranjal do a retroperitoneal donor nephrectomy and a robotic kidney transplantation. It was my first time seeing a robotic kidney transplant and it was so amazing. I met Dr. Himanshu Patel on that trip and I also had the honor of visiting Dr. HL Trivedi and his wife with Vivek. What a legacy Dr. Trivedi has left and I am so proud that APKD has been able to work together with Vivek, Himanshu, Pranjal and all the members of the IKDRC team to extend his wonderful vision.
 

"Since that meeting in Hong Kong, I have now made 12 trips to India and have become a big fan of Indian food and diversity of Indian culture. I have been so impressed with the passion and commitment of doctors across India, but none more so than at IKDRC. Along the way I have been fortunate to have been joined by Atul Agnihotri, Shridhar Hanchinal, and Trilly Mathew to expand our work in India. We are so grateful for the amazing example the IKDRC team has demonstrated in terms of what is possible when hard work and technology come together to saves the lives of patients with kidney disease. It is truly a joy to celebrate today with you our tenth anniversary of the work between IKDRC and APKD as we commemorate all that we have accomplished together!"

 ########

 Over the last decade I've blogged many times in connection with transplant progress in India.  Here's a selection related to this ten-year anniversary:

Wednesday, January 13, 2016  77 Kidney Exchange transplants in 2015 at one transplant center in India

Friday, April 14, 2017  A transplant center in India has done 300 kidney exchange transplants

Wednesday, May 3, 2017 Mike Rees in India to help remove obstacles to kidney exchange

Tuesday, May 21, 2019 Robot-assisted kidney transplantation in Ahmedabad, India.

 

Wednesday, February 3, 2021 Non-Simultaneous Kidney Exchange Cycles in India: new design, in Transplant International by Kute and Rees et al.

Thursday, October 13, 2022 The Dr H.L. Trivedi Oration at the Indian Society of Transplantation (ISOT) Meeting 2022

Tuesday, February 27, 2024  Stanford Impact Labs announces support for kidney exchange in Brazil, India, and the U.S.

Saturday, April 19, 2025 One Nation One Swap: National kidney exchange in India

 Thursday, August 7, 2025 Stanford conference on extending kidney exchange

 

Zhang Xuefeng (1984-2026), guided Chinese families through the college admissions process

 A Chinese college-admissions influencer has died, who helped families choose which colleges and majors to rank, after they received the results from the gaokao, the national admissions exam.

The NYT has the story:

China Mourned an Education Influencer. The Grief Was a Quiet Revolt.
Zhang Xuefeng helped people navigate the country’s unforgiving higher education system. The public outpouring after his death was a quiet rebuke to the punishing process.  By Li Yuan

 "Zhang Xuefeng became famous in China for telling students and their parents what few educators would: which majors were useless, which careers were dead ends and which dreams ordinary families could not afford.

“Knock out your children if they want to study journalism,” he famously said.

“The humanities all lead to service work, and service work, in one word, is sucking up” to clients.

...
"But when Mr. Zhang died last month, at 41, something uncommon in today’s China happened. In a country where large-scale, spontaneous public emotion is rarely tolerated, tens of thousands of people from all over the country showed up at his memorial service in the eastern city of Suzhou. They stood in line for hours to pay their respects, some carrying flowers, one clutching a college admission letter. On the Chinese internet, posts and videos about Mr. Zhang and his death drew more than six billion views in a single day, according to a media monitoring firm.

...

"The gratitude directed at Mr. Zhang, who had 27 million followers on the short-video platform Douyin, reflected the fears of ordinary Chinese families trying to navigate an increasingly opaque and unforgiving education system. The extraordinary mourning after his death revealed how much of contemporary China is living with that anxiety.

"Students and parents thanked him for helping them navigate the high-stakes process of choosing a college major in China. Through livestreams and consulting sessions, he explained which majors led to stable jobs, which industries were declining and which professional certificates were worth pursuing — information readily available to families with connections or advanced education but far harder for everyone else to find. 

...

"For decades, the general college entrance exam, known in Chinese as the gaokao, was widely seen as a pathway to changing one’s fate; it was brutally competitive but capable of delivering upward mobility. As universities expanded and the job market deteriorated, that promise weakened. Getting into college became easier. Turning a degree into security did not.
...

"In many provinces, families have less than two weeks between getting the results of the exam and the deadline to apply to college. In that time, they need to make sense of hundreds of majors, universities and career paths. 

...

"The families who turn to consultants like Mr. Zhang are not, for the most part, China’s elite. But neither are they the poorest. Wang described his clients as families in the broad middle: small-business owners, office workers, skilled laborers and lower-level state employees. They often have money to pay for guidance but lack the social capital or institutional knowledge needed to navigate the system confidently on their own. " 

Open Letter to President Trump on Iran Strategy From a Group of Concerned Economists

  Yesterday, just hours before President Trump's announced deadline for widespread destruction of power plants and bridges in Iran, a group of Iranian-American economists circulated this open letter, which I signed on to It began as folows:

An Open Letter to President Trump on Iran Strategy From a Group of Concerned Economists
"Dear President Trump,

While we share the Administration's concerns about the Islamic Revolutionary Guard Corps’ (IRGC) nuclear program and destabilizing activities, strikes on Iranian civilian infrastructure, including power plants, industries, bridges, and universities, some of which have already begun, are strategically counterproductive, escalating costs to Americans while reducing our ability to achieve America’s objectives.

Iran's ability to disrupt the Strait of Hormuz through mines, fast-attack boats, coastal missiles, and drones does not depend on power plants or refineries. Destroying civilian infrastructure removes Iran's incentive to reopen the Strait; it does not remove its capability to close it.

Striking infrastructure devastates the livelihood of 92 million civilians. Aside from its resulting humanitarian crisis, it will further widen the scope of the war and allow the IRGC to position themselves as defenders of the nation, and rebuild their badly damaged internal support. Infrastructure strikes and a prolonged war also let them blame economic misery on foreign aggression rather than their own mismanagement.  "

##########

This morning I don't find much evidence of it on the internet.

Professor Mostafa Beshkar  in Indiana has posted it on Twitter (as X used to be known), and  here it is in the Indiana student newspaper, with the signers (who you can also find here):

LETTER: To President Trump on Iran strategy from a group of concerned economists 

But open letters aren't just written, circulated and signed  to change policies (especially in a matter of hours). They also serve to express solidarity, and even as a shout into the void they let those concerned with Iran, and with America, express their fear and loathing of war crimes and boasts about the intention to commit them. 

Multi-pair kidney exchange comes to Karnataka

 Sophisticated kidney exchange is coming to more Indian States.

The Indian Express has the story from Karnataka:

Kidney donation to become easier as Karnataka okays multi-pair exchange
Until now, swap kidney donations were limited to two incompatible donor-recipient pairs. 

"In a significant move that could help patients awaiting a kidney transplant, the Karnataka Government has issued guidelines permitting multi-pair kidney paired swap transplantation. This will expand the scope of organ donation beyond the traditional two-way system.

The Karnataka Multi-Pair Kidney Exchange Transplantation Guidelines 2026 were issued via a government order on April 4.

“A significant number of donor-recipient pairs in Karnataka are unable to undergo transplantation on account of biological incompatibility… Applications have been received from registered transplant hospitals in Karnataka seeking approval for multi-pair Kidney Paired Exchange Transplantation involving three or more donor-recipient pairs,” the order said."

Could A.I. be good for scientists but bad for science?

 There has been recent attention to using LLMs to generate novel (and often correct) mathematical proofs, prompted by plain English prompts.

A recent Amazon blog post by Michael Kearns and Aaron Roth recounts how they have been able to collaborate with a LLM in the production of increasingly sophisticated proofs of new results. They anticipate that this is a development that will only continue to grow in usefulness. At the same time, they worry about what impact it may have both on the training of new mathematical scientists, and on the peer review process (as the cost of writing polished and correct papers falls faster than the cost of evaluating them for importance). Perhaps unsurprisingly, one of the first fields to feel the strain of this imbalance has been theoretical  research into machine learning models.

How AI is changing the nature of mathematical research  
What machine learning theorists learned using AI agents to generate proofs — and what comes next.

By Michael Kearns and Aaron Roth

“Specifically, how can intuition and “good taste” in scientific research be developed when AI automates many of the steps that have historically been used to train young researchers? Peer review is another challenge: AI-generated research papers, quickly churned out at scale, highlight the limitations of peer review and modern-day publishing structures and also exacerbate already emerging challenges to incentives for scientific success. Without claiming to have answers or solutions to these concerns, we are personally living through them and will discuss each in turn.
…
“Historically, people earn expertise in the mathematical sciences through struggle as junior researchers. PhD students spend years working through the details of technical arguments to gain hard-won intuitions about when a proof approach is promising, when they are being led astray by a problem, or what constitutes a novel and interesting research direction.

“But these aspects of being a researcher are exactly what AI tools are “giving away”. If doctoral students can simply ask AI for proofs — which is extremely tempting, especially when it is in service of advancing research — how do they develop the experience and skill that, for now at least, are required to use AI tools productively in the first place?
…
“Breaking and remaking peer review
“From our perspective, peer review is not only, or even primarily, a process to verify the correctness and quality of research. Rather, its purpose is to focus a scarce resource — the attention of the research community — in the right places. Science progresses as researchers build on each other’s work, but there is already too much work out there for anyone to keep up with. The publication process should help identify the most interesting and promising directions, so they can be more efficiently and thoroughly developed.
…
“AI tools make it much easier to produce work that looks polished and correct, dramatically lowering the barrier to generating “papers” that can be submitted to journals and conferences. Many of these papers are neither interesting nor actually correct — but discovering this requires significant effort from reviewers.

This is straining an already overburdened machine learning publishing ecosystem struggling with tens of thousands of submissions per venue. We have seen that reducing the time and effort needed to produce "a paper" — not necessarily a good paper — is beginning to destabilize our existing institutions for peer review. The most recent iterations of AI and ML conferences have seen the number of submissions growing by large multiples, with a significant number of papers polished by AI, but ultimately of low quality, making it surprisingly far through the review process before being noticed and called out.
“This is a problem across research fields, partially because it’s creating a market for AI-generated papers. This has in turn engendered a countermarket for AI-assisted detection of AI-generated papers — much like the familiar technological arms races around things like spam and its detection, but with the integrity of scientific publication at stake, not just the filtration of annoying or fraudulent e-mails.

…
“Without a serious, community-wide re-evaluation of peer review, AI threatens to arrest scientific progress at the community level even as it accelerates it at the level of individual researchers.” 

Moral Economics: Al Roth and Ray Fisman at Cambridge Public Library, Monday May 11

 Here's the invitation to a discussion I'll have in May with Ray Fisman, about Moral Economics.

Some of my Boston/Cambridge friends asked how to get tickets now because they're afraid it will sell out (the price is right), and others because they're afraid that if they don't come Ray and I will be speaking to an empty hall...

Alvin E. Roth at the Cambridge Public Library   Monday, May 11 at 6 pm

You can get tickets at this link. 

 

"Harvard Book Store and the Cambridge Public Library welcome Alvin E. Roth—Nobel Prize–⁠winning economist, the Craig and Susan McCaw Professor of Economics at Stanford University, and the George Gund Professor of Economics and Business Administration Emeritus at Harvard University—for a discussion of his new book, Moral Economics: From Prostitution to Organ Sales, What Controversial Transactions Reveal About How Markets Work. He will be joined in conversation by Ray Fisman—who holds the Slater Family Chair in Behavioral Economics at Boston University.
Ticketing

RSVP for free to this event or choose the "Book-Included" ticket to reserve a copy of Moral Economics and pick it up at the event. Following the presentation will be a book signing." 

Nonfiction Publishing, Under Threat, Is More Important Than Ever (New Republic)

 As an author with a forthcoming non-fiction book, it's both depressing to read that non-fiction book sales are down, but inspiring to read of the importance of books.

The New Republic considers the (diminishing) prospects and (continuing) importance of non-fiction books.

Nonfiction Publishing, Under Threat, Is More Important Than Ever
Cuts in publishing and book reviewing imperil the future of narrative nonfiction, and our understanding of the world around us.  by Paul Elie

 “The decline in sales of new nonfiction might reflect a changing information ecosystem,” Elizabeth Harris observed. “People looking for information can now easily turn to chatbots, YouTube, podcasts and other free online sources.” Last December, The Guardian cited NielsenIQ figures indicating a one-year drop of 8.4 percent in nonfiction book sales (twice that of fiction) and quoted a writer who had “heard publishers have soured on any nonfiction that isn’t ‘Hollywood friendly.’”

... 

"Fretful narratives about the demise of books and the rise of devices have been in play for half a century or longer. “Our world of books, like most other worlds now, is the arena of an increasingly bitter struggle for space, and for the limited reading time that a busy citizen in this electronic age can afford,” John Updike lamented when accepting the American Book Award in 1982. Narrative nonfiction in particular has faced headwinds in mass culture before. And in many respects, the challenges it faces are built in. Long fact is hard to publish and always has been. Reportage and research take time, resources, attention, and fortitude. A book can require several years to write and another year and a half to be edited, checked, printed, and publicized—only to wind up coming out during a news cycle dominated by a sex scandal, school shooting, pandemic, or war. It was as true half a century ago as it is today that readers expect to pay for fiction but are used to getting nonfiction passively through the media. 

...

"In societies where freedom is under threat, an informed citizen is countercultural and deep reading is an act of resistance. Just as protest and vigilance are essential, so is the ability to read and think. In a would-be autocracy, the autocrat aims to subsume our society’s particular narratives into his master narrative—in which his name fills the headlines, his voice and image dominate the broadcasts, and his airbrushed visage appears on the facades of government. To read a book, however, is to enter a narrative that stands outside the politics-and-media maelstrom. In a would-be autocracy, even a small bookstore—with hundreds of books, classic, recent, and current—is a space of contrary narratives, where truth is recognized as both essential and complicated." 

Stanford remembers John Roberts (1945-2026)

 Economist John Roberts, leader in organizational research, dies at 80
The Stanford professor’s work brought game theory to management practices in firms around the world. 

"Donald John Roberts, the John H. Scully Professor of Economics, Strategic Management and International Business, Emeritus, died Jan. 23 after a long illness. He was 80.

"His start at Stanford GSB was carefully cultivated. When economics professor Robert Wilson began growing the economics faculty at the business school in the late 1970s, he had already recruited an impressive group of young scholars. But he needed someone to shape the intellectual direction of the program.

"Wilson believed Roberts was that person.

At the time, Roberts was a young professor at Northwestern University’s Kellogg School of Management, already known for his teaching credentials and research in economic theory. Wilson persuaded him to join Stanford in 1980, bringing him west to help build what would become one of the most influential economics groups in academia.

“John played a central role in shaping the direction of the economics group in those years,” says Wilson, the Adams Distinguished Professor of Management, Emeritus, and winner of the Nobel Memorial Prize in Economic Sciences. “He had a remarkable ability to see where an idea could lead and to push it until the logic became clear.”

"Roberts remained at the school until his retirement in 2012. At Stanford GSB, he helped lead the doctoral program, mentored younger faculty, and played a central role in recruiting a generation of economists whose work reshaped the field. His four decades of research helped transform how economists study organizations and their management, bringing rigorous economic theory to questions about how firms function internally.

...
“Besides his scholarship, John was an institution builder who helped shape the intellectual culture of the school,” says David M. Kreps, the Adams Distinguished Professor of Management, Emeritus. “John helped create an environment where both ambitious research and professional education thrived. He was the personification of balanced excellence.”