Kidney exchange may (re)emerge in Korea

 Kidney exchange, which was pioneered in South Korea in the late 1990's, has largely been moribund there.  But here's a call to change that.

Reemerging kidney paired donation in Korea: simultaneous two-way swaps to overcome human leukocyte antigen and anatomic barriers
Eunjeong Kang1,2, Kyung Ok Min1, Hee Gyung Kang3, Yohan Ahn3, Eun Young Song4, Ara Cho5, Ahram Han5, Sangil Min5, Jongwon Ha5,6,7, Sehoon Park2, Yong Chul Kim2, Yon Su Kim2,8, Hajeong Lee2,8  Kidney Research and Clinical Practice 2026;j.krcp.25.391. DOI: https://doi.org/10.23876/j.krcp.25.391
 
Abstract
Background
South Korea first implemented kidney paired donation (KPD) to overcome ABO-incompatible living-donor kidney transplantation. Although utilization declined as desensitization matured, persistent desensitization failure and anatomic constraints have renewed interest in KPD within a regulated framework. We report a recent single-center experience.
Methods
KPD exchanges were coordinated within an institutional registry under national supervision. We retrospectively reviewed six consecutive, simultaneous two-way exchanges (12 recipients) from 2022 to 2025. We assessed predefined desensitization failure or anticipated failure with the intended donor, compared immunologic compatibility between intended and exchange donors, and recorded perioperative desensitization, graft function, delayed graft function (DGF), and biopsy-proven acute rejection (BPAR).
Results
Five of six exchanges were undertaken for immunologic reasons. All five met criteria for desensitization failure or anticipated failure to the intended donor, with positive crossmatch and high donor-specific antibody (DSA) burden. Reassignment to the exchange donor reduced risk, lowering maximum DSA mean fluorescence intensity (MFI) from 13,228 to 1,350 and total DSA MFI from 20,542 to 2,240, although selective desensitization was still required in some recipients with residual human leukocyte antigen or ABO incompatibility. The remaining exchange addressed an anatomic constraint (adult–pediatric size mismatch). At a median follow-up of 12.2 months (range, 0.9–42.1 months), no DGF or BPAR occurred; all grafts were functioning, and the median estimated glomerular filtration rate was 66.8 mL/min/1.73 m2.
Conclusion
KPD is a safe alternative when desensitization fails or is predicted to fail, including in highly sensitized and anatomically complex candidates. These findings support renewed implementation of KPD alongside selective desensitization in Korea. 

 

Celebrating science and democracy at the Hebrew University of Jerusalem, on Monday

 If the skies remain open, I'm on my way to Jerusalem, to participate in a twice-recheduled event at the Hebrew University of Jerusalem.  (It was first scheduled for June 2025, to coincide with HUJI's 100th anniversary, but it was postponed to June 2026 on account of war with Iran.  The June 2026 event was again postponed, for the same reason...)

Now, a week before Israeli elections (and less than a month before American midterm elections), amidst all the political polarization in both countries, I'm reminded that universities are one of the bastions of democracy. I don't doubt that most of the other honorees gathering in Jerusalem feel the same way. (I note that three of the honorary doctorate recipients have received the Nobel memorial prize in economics.) 

 Honorary Doctorate Recipients:
Prof. Joshua D. Angrist
Danna Azrieli
Dr. Naomi Azrieli O.C.
Dr. Sharon R. Azrieli CQ 
Prof. Shafi Goldwasser
Steven H. Lavin
Marc O. Mayer
Prof. Joel Mokyr
Yehuda Leon Poliker
Prof. Alvin E. Roth
Prof. Sabine Schmidtke

Bublick Prize Recipient:
Prof. Eliezer Rabinovici  

Rothberg Prize Recipient:
Eshel Gat

Honorary Fellowship Recipients:
Ronen Barel
Florence de Botton
Jean-François de Clermont-Tonnerre
Benjamin Horwood 
Dr. John Lourie
Prof. Malcolm Shaw KC
Dr. Wallace N. Weber
Zvi Yekutiel 

Here's a blurry photo that appeared on the front page of the 16 October Haaretz, with the names and nationalities of the honorees (sent to me by Assaf Romm)

 

Marilda Sotomayor is celebrated in Brasil, with an honorary doctorate at Universidade de Brasilia

 Marilda Sotomayor is increasingly recognized as among Brazil's most important economists.

 Consuni approves granting the title of Doctor Honoris Causa to Marilda Sotomayor 

 "The University Council (Consuni) approved, by acclaim, the granting of the title of Doctor Honoris Causa to the professor and mathematics Marilda Antonia de Oliveira Sotomayor. 

...

"Marilda Sotomayor is recognized for her contribution to Game Theory and Matching Theory, an area dedicated to the study of allocation mechanisms in two-sided markets. The opinion of the Special Commission highlighted its contribution to the consolidation of this field of research in Brazil and its international projection.

"Graduated in Mathematics from the Federal University of Rio de Janeiro (UFRJ), Marilda completed a master’s degree at the Institute of Pure and Applied Mathematics (Impa) and a doctorate from the Pontifical Catholic University of Rio de Janeiro (PUC-Rio), in partnership with Impa. During the postdoctoral degree at the University of California, Berkeley, she worked with David Gale, one of the founders of Matching Theory.

"Among her main contributions is the book Two-Sided Matching: A Study in Game-Theoretic Modeling and Analysis, published in 1990 in co-authorship with Alvin Roth. The work received the Lanchester Prize and became an international reference in the area. Marilda is also a member of the Brazilian Academy of Sciences and the American Academy of Arts and Sciences and has received, among other distinctions, the 2016 TWAS Award.

"The proposal to grant the title was presented by Professor Maurício Bugarin to the Department of Economics (ECO/Face) and encamped by the Faculty of Economics, Administration, Accounting and Public Policy Management (Face)."

 

########### 

 

 

How successfully have military measures limited the supply of cocaine?

 There are two ways of measuring the success of military measures to limit the supply of cocaine.  There's the military measure of how many people are killed and how much cocaine is confiscated. And there's the economic measure of how much cocaine is available to consumers, at what price and quality.

The WSJ has the story (of plunging prices and rising quality):

Why U.S. Airstrikes Are Failing to Stop the Global Cocaine Boom
Smugglers are shifting routes and using new tactics to evade military targeting, resulting in record supplies, plunging prices and high purity in the U.S. and Europe   by Juan Forero
 |
"BUENAVENTURA, Colombia—The Trump administration’s bombing campaign against cocaine-smuggling speedboats is starting to have an impact on the global drug trade—but not necessarily in a good way.

...

"Record supplies of cocaine still arrive in the U.S., Europe and as far away as Australia every day, cheaper and purer than they’ve been in decades, said law-enforcement officials across four continents. 

"President Trump has celebrated the airstrikes, noting his administration has “made tremendous strides in stopping the flow of illegal drugs into our country.” In the past 13 months, American military drones and aircraft have destroyed more than 70 vessels, killing nearly 240 crew members and depriving criminal groups of $1.5 billion in cocaine, according to U.S. officials. 

“The drugs coming in by sea are down by 97%,” Trump said in June. “We’re trying to figure out who the 3% are, because they are the bravest people on earth.”

...

"The scale of the trade is evident on the streets of drug-consuming countries, where supply is outstripping demand to the point that prices are plunging. In Miami, wholesale cocaine sold for about $16,500 a kilogram this summer, well below the historical $22,000 to $25,000 range. Similarly, European prices have plummeted from $45,000 to as low as $16,000 a kilogram in some cities. 

"In both markets, purity remains remarkably high, sometimes hitting 98% in Europe, because dealers no longer need to stretch supplies with adulterants. "

 

NBER Market Design Working Group Meeting, tomorrow at Stanford

 Here's the program for the NBER Market Design Working Group Meeting, Fall 2026

I'll be discussing Moral Economics with Canice Prendergast. 

Friday, October 16

8:00 am Continental Breakfast

 

9:00 am Personalized Recommendations Without Inducing Congestion: Mitigating Disparities in the NYC High School Match

Erica Chiang, Cornell University

Nikhil Garg, Cornell University

Jon Kleinberg, Cornell University

Rebecca Lichtenstein, New York City Public Schools

Brielle McDaniel, New York City Public Schools

Kristen O’Neil, New York City Public Schools

Kenny Peng, Cornell University

Eva Tardos, Cornell University

Dejaunique Thomas, New York City Public Schools

Lianna Wright, New York City Public Schools

 

9:45 am Who Gets What in Education: Can School Matching Improve Student Achievement?

Atila Abdulkadiroglu, Duke University and NBER

Parag A. Pathak, Massachusetts Institute of Technology and NBER

Christopher R. Walters, University of California, Berkeley and NBER

 

10:30 am Break

11:00 am Searchable Menus

Piotr Dworczak, Northwestern University

Frank Yang, Stanford University

 

11:45 am Two-Sided Matching with Partial Participation

Avinatan Hassidim, Bar-Ilan University

Assaf Romm, Hebrew University of Jerusalem

Ran Shorrer, The Pennsylvania State University

 

12:30 pm Lunch and Conversation with Al Roth about his latest book, "Moral Economics" with Canice Prendergast as Moderator

 

2:30 pm Clearing Multi-Unit Markets with Simple Pricing

Ali Makhdoumi, Duke University

Saša Pekeč, Duke University

Xinchang Wang, Duke University

 

3:15 pm Quota Marketplace: Dynamic Pricing for Efficient Allocation of ML Training Resources

Vasilis Gkatzelis, Drexel University

Renato Paes Leme, Google Research

Ian McFarlane, Google Research

Nehal Mehta, Google Research

Vahab Mirrokni, Google Research

Balasubramanian Sivan, Google Research

Mihai Tiuca, Google Research

Amin Vahdat, Google Research

Soheil Hassas Yeganeh, Google Research

 

4:00 pm Break

 

4:30 pm One-Shot Pricing for Hands-Off-the-Wheel Advertising Markets

Emerson Melo, Indiana University

Matthew Shum, California Institute of Technology

Rakesh Vohra, University of Pennsylvania

 

5:15 pm Paying for Information, Not for Clicks: A Block-Level Publisher Content Marketplace for AI Answers

Markus Mobius, Microsoft Research

Nicole Immorlica, Microsoft Research

Oliver Kiss, Spreadmonitor

Brendan Lucier, Microsoft Research

Ishan Mahajan, Microsoft Research

Jingyi Qiu, University of Michigan School of Information

Tanya Rosenblat, University of Michigan

David M. Rothschild, Microsoft Research

Andras Sari, Central European University

Colin Watson, Microsoft Research

6:30 pm Group Dinner 

 

Saturday, October 17

8:00 am

Continental Breakfast

9:00 am

Screening for Usage

Justin Hadad, Stanford University

Kyle Woodward, Assign Group

 

9:45 am

Pricing the Right to Renege in Search Markets: Evidence from Trucking

Richard Faltings, University of California, San Diego

 

10:30 am

Break

 

11:00 am

Competition and Welfare in Airport Slot Allocation

Sebastian D. Bauer, Universidad Carlos III de Madrid

11:45 am

Road Pricing under Heterogeneity

Itai Ater, Tel Aviv University

Brad Ross, University of Pennsylvania

Adi Shany, Tel Aviv University

Shoshana Vasserman, Stanford University and NBER

 

12:30 pm

Boxed Lunch and Adjourn

Kidney exchange in India at a national scale: a growing consensus

There's growing consensus in India on moving towards a nationwide kidney exchange program. 

Kute V, Kumar A, Balwani M et al.
Operational guidelines for kidney swap transplantation in India: an ISOT-NOTTO Delphi consensus
The Lancet Regional Health – Southeast Asia, 2026; 0 

 

 

 Among the consensus recommendations is this one, which summarizes the general positive tone adopted for national kidney exchange.

"Each transplant center should initiate and expand swap transplantation, given that it is legal, cost-effective, yields better outcomes, and can help prevent unethical commercial transplants by improving access. Multicentric swap transplantation programmes should roll out in phases: start with intra-city exchanges, then intra-state, and eventually inter-state and national collaborations. This phased approach ensures growing scale is matched with operational readiness, providing safe, equitable, and efficient transplants across regions." 

The University of Cincinnati celebrates Steve Woodle

Dr. Steve Woodle, one of the pioneers of kidney exchange, is being honored in Cincinnati.  You can read of his many distinctions below, but here's a striking one: he is the "the first liver transplant recipient to perform a liver transplant."

2026 Daniel Drake Medals  The University of Cincinnati College of Medicine’s highest honor 

E. Steve Woodle, MD

E. Steve Woodle, MD

Woodle, professor of surgery and the William A. Altemeier endowed chair in surgery at the College of Medicine, is a multiorgan transplant surgeon and transplant immunologist who has spent more than four decades advancing the understanding of organ rejection and pioneering immunosuppressive therapies that have reshaped transplantation. Earlier in his career at the University of Chicago, he performed a liver transplant on a 10-day-old infant, setting a Guinness World Record for the youngest liver transplant recipient. He joined the College of Medicine in 1999 and directed the Division of Transplantation for nearly two decades, building an internationally recognized program of clinical and research excellence. In 2001, he performed Ohio’s first allogeneic islet transplant for type 1 diabetes. After undergoing his own liver transplant in 2003, Woodle returned to the operating room and became the first liver transplant recipient to perform a liver transplant.

Woodle has helped originate several therapeutic approaches now considered standard in transplantation. As a fellow, he conceived the genetic re-engineering of OKT3, the first FDA-approved monoclonal antibody — work later developed into teplizumab (Tzield), which the FDA approved in 2022 as the first immunomodulatory therapy for type 1 diabetes. He was the first investigator to introduce plasma cell-targeted therapy for a non-malignant human disease, using proteasome inhibitors to treat antibody-mediated rejection in kidney transplant recipients. He also pioneered corticosteroid-free immunosuppression, including the field’s landmark double-blind, placebo-controlled trial of early corticosteroid withdrawal. He helped conceive and establish clinical kidney exchange for incompatible living-donor pairs, publishing the field’s first peer-reviewed description in the New England Journal of Medicine in 1997. Kidney exchange now accounts for roughly one in five living-donor kidney transplants in the U.S.

His scholarship includes more than 400 scientific publications cited more than 22,000 times, and he has delivered more than 700 invited lectures and mentored generations of transplant surgeons, physicians and pharmacists. In 2025, he received the American Society of Transplantation’s Senior Achievement Award in Clinical Transplantation and was named an Ashbel Smith Distinguished Alumnus by the University of Texas Medical Branch, where he earned his medical degree.

Featured photo at top: Daniel Drake Medal. Photo/University of Cincinnati.