Market Design: A decade of progress in kidney exchange in India

Friday, April 10, 2026

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."
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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!"

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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.