Kidney exchange comes to Hungary

Péter Biró  writes with good news about kidney exchange in Hungary.

 Here's the announcement from the  University of Pécs, of the first kidney exchange performed in Hungary, following the first legislation passed to legalize kidney exchange in 2014. (And more details follow from a second announcement below.)

The first cross-donation kidney transplant was performed in Hungary at the University of Pécs Clinical Center  2026.01.29

"The first cross-donation kidney transplant performed in Hungary a few days ago can be considered a new milestone in the history of organ transplantation in Hungary. Within the framework of the living donor kidney exchange program, two women received new kidneys at the Department of Surgery of the University of Pécs Clinical Center (PTE KK), which gives them the opportunity for a better quality of life. It is particularly interesting that in both cases the organ donor was a male member of the other couple.

...

"In his speech, Dr. Péter Szakály, Head of Department of the Department of Surgery of the University of Pécs, emphasized that: The establishment of a national pool was of fundamental importance in this program, and this program will be able to operate successfully in the future as well if there are as many such couples as possible. He also added that compared to traditional kidney transplantation, living donor transplantation is always a much greater challenge (...) Transplantation with a living donor comes with increased responsibility, as it involves a healthy donor. In this case, two surgeries were performed at the same time: Ádám Varga, assistant professor, and I simultaneously removed and replaced the organs between the two pairs from the adjacent operating room. 

"Since 2014, the law allows this type of transplant, but no specific surgeries have been performed so far. Recognizing this shortcoming, at the initiative of the National Hospital Administration, the four kidney transplant centers in Hungary and the Regional Kidney Transplant Committees operating there, in cooperation with the National Blood Transfusion Service, have developed a nationally uniform program in accordance with the legislation in force, which ensures equal opportunities for all patients who voluntarily enter the program. This became the living donor kidney transplant exchange program, which was launched in Hungary on June 21, 2024. The search for optimally compatible pairings between the pairs applying for the program is carried out with the help of a software developed for this purpose." 

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And here is the emailed announcement forwarded by Peter Biro, who has been a champion of kidney exchange in Europe for many years now:

Dear EURO-KEP Colleagues,

 

We are pleased to inform you that we have reached a significant milestone within the Hungarian Kidney Paired Kidney Exchange Program (HKEP), in line with the objectives of the EURO-KEP initiative.

 

On January 20, 2026, the first two kidney transplants were successfully performed in Hungary within the national living donor kidney exchange program. The surgeries took place at the University of Pécs Clinical Centre, marking the first realization of kidney cross-over donation in the country.

We believe that this milestone, supported by a well-structured professional and patient information campaign lasting more than a year and a half, will contribute to increasing the number of living donor kidney transplants and encourage more patients and voluntary donors to join kidney exchange programs. This, in turn, will support further kidney exchanges and improve equal access to transplantation.

 

Chronology and key developments of the Hungarian KEP

• June 2024 – With the support and authorization of the National Directorate General for Hospitals (OKFŐ), a nationally unified kidney paired exchange program was launched, coordinated by the National Blood Transfusion Service, with the participation of all four Hungarian kidney transplant centers and regional waiting list committees.
• Since the launch – The matching algorithm has been run every three months; to date, six matching runs have been completed, involving 57 donors and 44 recipients. The seventh run is scheduled for tomorrow.
• July 2025 – A key legislative amendment entered into force, allowing:
• simultaneous transplants among more than two donor–recipient pairs in a closed chain,
• transplant surgeries to be performed in different centers, enabling patients to remain at their original listing centers and
• not only incompatible pairs can join the program, but compatible pairs in the hope of better matching.
• Following the legal amendment, an updated and detailed printed patient information package was distributed nationwide, with the involvement of all dialysis units and transplant centers.
• During the optimization process, a clinically acceptable match was identified between two married couples. In both cases, the male partner donated a kidney to the female recipient of the other couple. The transplant surgeries were performed on 20 January 2026 at the Surgical Clinic of the University of Pécs Clinical Centre. In both cases, graft function started immediately. The recipients and donors are in good condition and both patients were discharged home on Friday.

We consider this achievement a significant milestone in Hungarian transplantation and a meaningful contribution to the shared European objectives of the EURO-KEP project. We remain committed to continuing this work in the service of saving lives.

 

Best regards,

 

Dr. Sándor Mihály, Ph.D  
Director of transplantation

Honorary College Associate Professor at Semmelweis University

General Secretary of the Hungarian Transplant Society

EDTCO Past-Chair 2023-2025

 

 

Organ Coordination Office

Central Waiting List Office

National Organ and Tissue Donation Opting-out Registry

Hungarian Stem Cell Donor Registry

 

Kidney exchange in Brazil (a clinical trial)

Here's a video in which Mike Rees, the founder of the Alliance for Paired Kidney Donation (APKD) describes how (with the help of a grant from Stanford) the APKD is helping Brazilian transplant docs get kidney exchange going there. 

 

Earlier:

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

 

Thursday, October 10, 2024  Kidney exchange in Brazil, continued (with pictures)

 

 

History of the U.S. National Science Foundation (NSF)

 The NSF has played a key role in American science, and risks being collateral damage in the war against science.

Here is a their history web page:

History of the U.S. National Science Foundation 

Like many scientists, I'm deeply grateful for their support, particularly their early support. 

 The section "NSF's history and impacts: A brief timeline" mentions some accomplishments decade by decade, including this for the 2010's

    2010

"NSF-supported researchers use economic matching theory to develop a kidney exchange program that dramatically improves efficiency and doctors' ability to match organs. For his work in this area, Alvin Roth shares the 2012 Nobel Memorial Prize in Economic Sciences."

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All my posts on NSF.  

Four international kidney exchange programs: 3 achieve substantial success

 Here's a paper reporting on the experience of four cross-border kidney exchange programs, whose experience teaches an important lesson.  In particular (see the figure below), one of  the programs is run by Spain, Italy and Portugal, whose  total population of approximately 118 million people is far larger than the combined population of the other three*, but manages to do less than 5% of the total cross-border exchanges, far fewer than any of the others.  Despite its size, the Spain-Italy-Portugal program only tries to match hard-to-match patient-donor pairs with other hard-to-match pairs, unlike the other three programs.

 International Kidney Paired Donation Programs: Evolution and Practices of 4 Large Collaborations
Klimentova, Xenia PhD1; Domínguez-Gil, Beatriz MD, PhD2; Viana, Ana PhD1,3; Manlove, David PhD4; Andersson, Tommy PhD5; Ashkenazi, Tamar RN, PhD6; Berlakovich, Gabriela MD7; Böhmig, Georg A. MD8; Burton, Jo RN, PGDip9; Coll, Elisabeth MD, PhD2; Dittmer, Ian FRACP9; Fiaschetti, Pamela MD10; Fronek, Jiri MD, PhD11; Hughes, Peter D. MBBS, PhD12,13; Ivo da Silva, Margarida MD14; Mor, Eytan MD15; Viklický, Ondřej MD, PhD16; Weinreich, Ilse Duus BMLS17; Ferrari, Paolo MD, FRACP18,19
Transplantation ():10.1097/TP.0000000000005602, December 24, 2025. | DOI: 10.1097/TP.0000000000005602

"Plain Language Summary: Kidney paired donation (KPD) programs are organized in various countries to facilitate the donation of kidneys from willing but incompatible donors by matching them with pairs in similar situations. These programs often struggle with an accumulation of difficult-to-match recipients and small pools of incompatible pairs. To address this, several international collaborations have emerged to expand the pool sizes and increase the number of transplants by “exchanging” donors’ kidneys across countries. We identified 4 established international KPD programs, each supported by protocols and agreements signed by the participating parties. Each program is presented separately, detailing its historical establishment, operational aspects, and statistics on pool characteristics and performance. Following this, we provide a comparative analysis of key aspects across the 4 programs. Each program has its unique context and specificities. Even though 3 of 4 collaborations started just before the COVID-19 pandemic, they have collectively facilitated >450 transplants. This underscores the importance of further developing these collaborations to share practices and experiences, and to facilitate more transplants, particularly for difficult-to-match recipients. Three of the 4 presented collaborations are either fully operated or led by European countries. This highlights the crucial role of ongoing international cooperation in the development of KPDs, in particular in Europe. By further promoting collaboration among countries, we can facilitate pan-European exchanges and improve access to live kidney transplants for patients in need.

 ...

"A fundamental difference between the programs is their collaboration model. STEP, ANZKX, and the Czech-Austrian-Israeli collaboration operate as “merged pool” model, where all participating pairs are combined for joint matching runs. For STEP and ANZKX, no other matching runs are conducted by partners at any level (hospital or national), whereas in the Czech-Austrian-Israeli collaboration, the Austrian and Israeli partners report performing local exchanges whenever compatible pairs are identified.
 

"In contrast, KEPSAT uses a “sequential pool” model, where national matches are attempted first, and only unmatched pairs are entered into the international pool. It is recognized that the last 2 strategy strategies may lead to a fragmented market, potentially limiting matches for highly sensitized patients, as easier-to-match pairs are removed beforehand."

 It's ironic that a program that appears to be intended primarily to help hard-to-match pairs is organized in a way that limits them in this way.

The paper concludes on an optimistic note (with which I fully agree):

"In conclusion, ongoing international cooperation is essential for advancing KPD programs globally. Expanding cross-border exchanges and improving access to kidney transplants can greatly benefit patients worldwide. Additional strategies, such as NDADs, desensitization protocols, and the inclusion of compatible pairs, can further enhance the effectiveness of both national and international programs. Oversight of these initiatives is crucial to safeguarding the welfare of both donors and recipients, as well as to maximizing the success rates of kidney transplants.
 

"Looking ahead, new initiatives, and projects, funded by international health organizations, such as the European Kidney Paired Exchange Programme project (https://www.hnbts.hu/euro-kep/project), funded by EU4Health and starting in November 2024, aim to expand global collaboration among KPD programs, building on and strengthening existing partnerships. This increased international cooperation is expected to create additional opportunities for patients in need of kidney transplants worldwide, making life-saving transplants accessible to more individuals regardless of their geographic location."

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Earlier: Portuguese transplant docs noted the problem and argued for more global kidney exchange:

Tuesday, March 12, 2024 Kidney exchange between Portugal and Spain, and prospects for global kidney exchange

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*Notes on population:

Spain: 49 million; Italy 59 million; Portugal 10 million ; KEPSAT total pop =  approx 118 million

 Australia 28 million; NZ 5 million: ANZKX total pop approx 33 million

Austria: 9 million, Czech Republic  11 million, Israel 10 million: AT-CZ-IL total 30 million

Sweden: 11 million; Norway:  6 million; Denmark 6 million; Finland  6 million: STEP total approx 29 mil

NKR in the NYT

 Today's NYT has a story on the country's largest kidney exchange network, a private company with opaque finances called National Kidney Registry (NKR). The story also raises questions about some of the promises NKR makes through a voucher program.

 How One Father Created an Organ Empire.  The National Kidney Registry has matched thousands of kidney donors with recipients. It has also paid millions of dollars to a company owned by its founder.    By  Danielle Ivory, Grace Ashford and Robert Gebeloff 

 "Since its founding, N.K.R. has enabled nearly 12,000 such swaps, called paired donations, far more than any other public or private program. The organization’s focus on technology and efficiency has jolted a sluggish system, many health experts said.

But at the same time, N.K.R. has created a multimillion-dollar business with considerable power over the flow of thousands of organs, according to interviews with more than 100 people in transplant medicine and a review of business records. Many doctors told The Times the stakes of these lifesaving exchanges were too high to be managed by a private company with little government oversight.

...

"The organization was a nonprofit for more than a decade, but during that period paid at least $39 million for technology and other services to a company owned by Mr. Hil, charity filings show. In 2023, N.K.R.’s commercial operations were sold to a new for-profit company owned by Mr. Hil, making its finances much more opaque. 

...

“It’s basically a money transfer,” said Dr. Lloyd Ratner, a surgeon at Columbia University who performed the second-ever paired transplant in the country. He said the hospital had parted ways with N.K.R.

...

"One of N.K.R.’s most innovative policies, many doctors said, is known as voucher donation: Donors can choose to give their kidneys immediately, in exchange for organ vouchers their loved ones redeem later.

"This arrangement has helped N.K.R. expand its pool. But vouchers add risk for donors giving on behalf of hard-to-match patients. They might go through surgery months or even years before their loved ones get a match. Matches are especially unlikely, doctors said, for “very highly sensitized” patients who carry antibodies likely to reject a transplant.

...

" Doctors told The Times that they knew of some patients who became too sick or died before they redeemed their vouchers."

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Not mentioned in the article is the Alliance for Paired Kidney Donation (APKD) a smaller, older, highly ethical non-profit kidney exchange network founded by the transplant surgeon Mike Rees (with whom I often work). 

Kidney exchange updates

 Here are three kidney papers and proposals that I've noted recently,  which will have implications for the growing interest in international kidney exchange on a global scale:

Klaassen MF., de Klerk M, Dor FJ.M.F., Heidt S, van de Laar SC., Minnee RC., van de Wetering J, Pengel LH.M. and de Weerd AE. (2025) Navigating a Quandary in Kidney Exchange Programs: A Review of Donor Travel versus Organ Shipment. Transpl. Int. 38:14804. doi: 10.3389/ti.2025.14804

Abstract:  In multicenter kidney exchange programs (KEPs), either the explanted kidney must be shipped, or the donor must travel to the transplanting center. This review describes the available data on these two approaches and formulates recommendations for practice. We searched for studies addressing organ shipment or donor travel in KEPs. Data were categorized into four domains: cold ischemia time (CIT), logistics, donor/recipient perspectives and professional perspectives. From 547 articles screened, 105 were included. Kidneys are shipped in most countries. Prolonged CIT due to shipment may increase the risk of delayed graft function, but does not seem to impact graft survival. Planning the shipment requires a robust logistical framework with guaranteed operating room availability. Donor travel is reported to be both emotionally and financially distressing for donors and exposes them to inconsistencies in donor evaluation and counseling across centers. Reduced willingness to participate in KEP when travelling was reported by 36%–51% of donors. Professionals generally support offering organ shipment to donors not willing to travel. In conclusion, the decision between donor travel or organ shipment should be tailored to local circumstances. Healthcare professionals should prioritize minimizing barriers to KEP participation, either by facilitating organ shipment or reducing the burden of donor travel. 

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Neetika Garg, Joe Habbouche, Elisa J. Gordon, AnnMarie Liapakis, Michelle T. Jesse, Krista L. Lentine,
Practical and ethical considerations in kidney paired donation and emerging liver paired exchange,
American Journal of Transplantation,
Volume 25, Issue 11,  2025, Pages 2292-2302,
ISSN 1600-6135,  https://doi.org/10.1016/j.ajt.2025.07.2459.
(https://www.sciencedirect.com/science/article/pii/S1600613525028382)
 

Abstract: Since the first kidney paired donation (KPD) transplant in the United States in 1999, the volume and scope of KPD has expanded substantially, accounting for nearly 20% of living donor kidney transplants in 2021-2022. This review article discusses the practical and ethical issues specific to paired donor exchange that patients, transplant centers, and exchange programs commonly encounter. Access to paired donor exchange and education of candidates regarding the potential benefits, risks, and logistics of KPD are important considerations. Transplant centers and patients must consider practical issues including wait times, allocation and matching strategies, assessment of organ quality, complex donors, cold ischemia time, and risks of broken chains. Protections available to donors from current KPD programs, the potential psychosocial effects, and the ethical concerns related to variable access and the proprietary nature of private exchange programs are also discussed. More detailed, timely data collection at a national level, and ability to merge national data with individual donor exchange registries will enable the analysis of the impact and outcomes of future trends in paired donation. KPD experience and key concepts may inform liver paired exchange, which has been used internationally to expand living donor liver transplantation and is emerging in the United States.

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Alliance for Paired Kidney Donation (APKD) Launches Wish Upon a Donor: A Hope-Focused Advocacy Program Helping Kids Who Need Kidneys Find Living Donors

"TOLEDO, OHIO / ACCESS Newswire / December 9, 2025 / The Alliance for Paired Kidney Donation (APKD) is proud to announce Wish Upon a Donor, a groundbreaking program that amplifies the voices of families fighting for a better and brighter future for their child. While pediatric kidney patients cannot advocate for themselves, their parents can - and too often, they face this battle alone. Wish Upon a Donor helps families share their child's story, shining a light on their hopes, dreams, and urgent need for a living kidney donor.

...

"The onboarding process is fast and simple, taking just 10-15 minutes to complete, and finalized videos are sent to patients in just one to three days. Participation is free, and patients retain full control over how and where their stories are shared.

Wish Upon a Donor offers a range of support for families as they seek living donors, including:

Production of a personalized, high-quality video designed to reflect the patient's wishes, personality, and future - not just their disease

Dedicated campaign webpage to make it easy to convert interest into action

QR-coded postcards and magnets for sharing in local communities

Social media guidance to help families and supporters spread the word

Spanish- and English-language outreach materials for broader access

A living donor mentor to answer any non-medical questions about the process

"Wish buddy" volunteers to assist with video narration and/or sharing patient videos with a broader audience

When interest is generated through the Wish Upon a Donor campaign, APKD ensures both patients and transplant centers are effectively supported with guidance grounded in real-life experience from a dedicated living donor mentor. The organization manages all incoming donor inquiries, educates potential donors on the process, protections, and realities of living donations, and then refers qualified donors to an appropriate transplant center partner. APKD maintains communication and support throughout the evaluation and donation process. This approach empowers potential donors with education while easing the burden on transplant centers."
 

The Union of Concerned Scientists celebrates the NSF

 The Union of Concerned Scientists reminds us of some of many things government support of science has contributed to:

What Do Duolingo, The Magic School Bus, and James Bond Have in Common? The US National Science Foundation 

"Its story begins with President Franklin D. Roosevelt, who during World War II recognized the decisive role that scientific research played in national success. As the war ended, Roosevelt envisioned a way to carry that same scientific energy into peacetime; to support knowledge not just for defense, but for discovery. This vision became law under President Harry S. Truman in 1950 with the National Science Foundation Act , establishing a federal agency devoted to “promoting the progress of science” and “advancing the national health, prosperity, and welfare.” 

"Today, NSF accounts for only 0.1% of federal spending but supports roughly a quarter of all federally funded basic research at US colleges and universities. And that research underpins many of the everyday technologies we rely on. 

"75 Years of benefits for the American public 
Ever watch The Magic School Bus or Bill Nye the Science Guy? Those Millennial science classics were funded by NSF. When your local meteorologist points to a Doppler radar image tracking storms or hurricanes, that technology too has NSF roots. If you’ve ever undergone an MRI scan, used American Sign Language (ASL) resources, or benefited from a kidney exchange program, NSF funding helped make those possible."

...

and much more at the link...  

Ethical considerations and global cooperaton in transplantation, Wednesday in Cairo

It's Wednesday morning in Cairo, and here's today's conference schedule, which will include discussion of (and voting on) global cooperation in transplantation. (See my earlier post for context.) 

 

8:00 AM 08:30 AM	Opening Session of Ethical Consensus Global Consensus on Emerging Ethical Frontiers in Transplantation: Innovations & Global Collaboration	HALL A
Strategic Co-Leaders (Alphabetical)	Alvin E. Roth (Stanford University, USA) John Fung (University of Chicago, USA) Mark Ghobrial (Methodist Hospital, Houston, USA) Osama A Gaber (Methodist Hospital, Houston, USA) Sandy Feng (UCSF, USA) Valeria Mas (University of Maryland, USA)
Chairs (Alphabetical)	Ahmed Elsabbagh (University of Pittsburgh, USA) Medhat Askar (Baylor University, USA) Mohamed Ghaly (Hamad Bin Khalifa University, Qatar) Mohamed Hussein (National Guard Hospital, KSA)
Scientific Committee (Alphabetical)	Abdul Rahman Hakeem (King’s College Hospital, UK) Dieter Broering (KFSHRC, KSA) Hermien Hartog (Groningen, the Netherlands) Hosam Hamed (Mansoura University, Egypt) Manuel Rodriguez (Universidad Nacional Autónoma de México, Mexico) Matthew Liao (Center for Bioethics, New York University, USA) Nadey Hakim (King’s College, Dubai, UAE) Stefan Tullius (Harvard Medical School, USA) Varia Kirchner (Stanford University, USA) Wojciech Polak (Erasmus Medical Center, Rotterdam, the Netherlands)
Leadership of Jury Committee (Alphabetical)	Chair: John Fung (University of Chicago, USA) Vice-Chairs Hatem Amer (Mayo Clinic, Rochester, USA) Lloyd Ratner (Columbia University, USA) Maye Hassaballa (Cairo University, Egypt)
08:30 AM 09:30 AM	State of Art Lecture (1, 2)	HALL A
Chairpersons (Alphabetical)	Mahmoud El-Meteini (Ain Shams University, Egypt) Mehmet Haberal (Baskent University, Turkey) Sandy Feng (UCSF, USA)
08:30 AM 09:00 AM	From Dr. Starzl to the Future: The Evolution of Transplantation and the Call to Continue the Journey John Fung (University of Chicago, USA)
09:00 AM 09:30 AM	Organ Transplant Ethics: How Technoscientific Developments Challenge Us to Reaffirm the Status of the Human Body so as to Navigate Innovation in a Responsible Manner Hub A.E. Zwart (Erasmus University Rotterdam, Netherlands)
09:30 AM 11:00 AM	Working Group 1:	HALL A
Chairpersons (Alphabetical)	Ali Alobaidli (Chairman of UAE National transplant committee) Hermien Hartog (Groningen, The Netherlands) Khalid Amer (Military Medical Academy, Egypt) Lloyd Ratner (Columbia University, NY, USA) Thomas Müller (University Hospital Zurich, Switzerland)
09:30 AM 09:50 AM	Keynote Lecture: Xenotransplantation: Scientific Milestones, Clinical Trials, Risks, and Opportunities Jay Fishman (MGH, USA)
09:50 AM 11:00 AM	WG1 Presentation & Panel Voting Matthew Liao (Center for Bioethics, New York University, USA) Hosam Hamed (Mansoura University, Egypt) Daniel fogal (New York University, USA)
11:00 AM 11:30 AM	Coffee Break
11:30 AM 01:00 PM	Working Group 2:	HALL A
Chairpersons (Alphabetical)	Daniel Maluf (University of Maryland, USA) Karim Soliman (University of Pittsburgh, USA) Marleen Eijkholt (Leiden University Medical Centre, Netherlands) Refaat Kamel (Ain Shams University, Egypt) Varia Krichner (Stanford University, USA)
11:30 AM 11:50 AM	Keynote Lecture: Smart Transplant: How AI & Machine Learning Are Shaping the Future Dorry Segev (NYU Langone, USA)
11:50 AM 01:00 PM	WG2 Presentation & Panel Voting Hub A.E. Zwart (Erasmus University Rotterdam, Netherlands) Varia Krichner (Stanford University, USA) Eman Elsabbagh (Duke University, USA) Mohammad Alexanderani (University of Pittsburgh, USA)
01:00 PM 02:30 PM	Working Group 3:	HALL A
Chairpersons (Alphabetical)	Ahmed Marwan (Mansoura University, Egypt) Ashraf S Abou El Ela (Michigan, USA) Mostafa El Shazly (Cairo University, Egypt) Peter Abt (UPenn, USA) Philipp Dutkowski (University Hospital Basel, Switzerland)
01:00 PM 01:20 PM	Keynote Lecture: Ischemia-Free Transplantation: A New Paradigm in Organ Preservation and Transplant Medicine Zhiyong Guo (The First Affiliated Hospital of Sun Yat-sen University, China)
01:20 PM 02:30 PM	WG3 Presentation & Panel Voting Jeffrey Pannekoek (Center for Bioethics, Cleveland Clinic, USA) Abdul Rahman Hakeem (King’s College Hospital, UK) Georgina Morley (Center for Bioethics, Cleveland Clinic, USA)
02:30 PM 03:30 PM	Lunch Symposium	HALL B
03:30 PM 05:00 PM	Working Group 4:	HALL A
Chairpersons (Alphabetical)	David Thomson (Cape Town University, South Africa) Lucrezia Furian (University Hospital of Padova, Italy) May Hassaballa (Cairo University, Egypt) Abidemi Omonisi (Ekiti State University, Nigeri) Vivek Kute (IKDRC-ITS, Ahmedabad, India)
03:30 PM 03:50 PM	Keynote Lecture: Framing the Conversation: Ethical considerations at the foundation for global transplant collaboration Marleen Eijkholt (Leiden University Medical Centre, Netherlands)
03:50 PM 05:00 PM	WG4 Presentation & Panel Voting Alvin Roth (Stanford University, USA) Marleen Eijkholt (Leiden University Medical Centre, Netherlands) Michael Rees (University of Toledo, USA) Ahmed Elsabbagh (University of Pittsburgh, USA) Nikolas Stratopoulos (Leiden University Medical Centre, Netherlands)
05:00 PM 05:30 PM	Closing Session of Ethical Consensus Global Consensus on Emerging Ethical Frontiers in Transplantation: Innovations & Global Collaboration	HALL A
Strategic Co-Leaders (Alphabetical)	Alvin E. Roth (Stanford University, USA) John Fung (University of Chicago, USA) Mark Ghobrial (Methodist Hospital, Houston, USA) Osama A Gaber (Methodist Hospital, Houston, USA) Sandy Feng (UCSF, USA) Valeria Mas (University of Maryland, USA)
Chairs (Alphabetical)	Ahmed Elsabbagh (University of Pittsburgh, USA) Medhat Askar (Baylor University, USA) Mohamed Ghaly (Hamad Bin Khalifa University, Qatar)
05:10 PM 05:30 PM	State of Art Lecture (3): Reflections from a Transplant Pioneer: Ethics, Policy, and the Future of Global Collaboration Ignazio R. Marino (Thomas Jefferson University, Italy/USA)

 

Kidney exchange in Operations Research (and elsewhere)

 Kidney exchange is an important medical innovation that has given rise to literatures not only in medicine but in economics, computer science and operations research. (That diversity of literatures is related to the interdisciplinary growth of market design.)

Here's a new survey of the OR literature on kidney exchange.

Mathijs Barkel, Rachael Colley, Maxence Delorme, David Manlove, William Pettersson, Operational research approaches and mathematical models for kidney exchange: A literature survey and empirical evaluation,  European Journal of Operational Research, 2025, ISSN 0377-2217, https://doi.org/10.1016/j.ejor.2025.08.059.

Abstract: Kidney exchange is a transplant modality that has provided new opportunities for living kidney donation in many countries around the world since 1991. It has been extensively studied from an Operational Research (OR) perspective since 2004. This article provides a comprehensive literature survey on OR approaches to fundamental computational problems associated with kidney exchange over the last two decades. We also summarise the key integer linear programming (ILP) models for kidney exchange, showing how to model optimisation problems involving only cycles and chains separately. This allows new combined ILP models, not previously presented, to be obtained by amalgamating cycle and chain models. We present a comprehensive empirical evaluation involving all combined models from this paper in addition to bespoke software packages from the literature involving advanced techniques. This focuses primarily on computation times for 49 methods applied to 4320 problem instances of varying sizes that reflect the characteristics of real kidney exchange datasets, corresponding to over 200,000 algorithm executions. We have made our implementations of all cycle and chain models described in this paper, together with all instances used for the experiments, and a web application to visualise our experimental results, publicly available.
Keywords: Combinatorial Optimisation; OR in health services; Kidney paired donation; Cycle packing; Computational experiments
 

"Better to exchange kidneys than bombs."

 Some coffee cups  should naturally come in pairs, so that you have one for a friend in need. (These recently arrived in the mail, from Laurie Lee)

Better to exchange kidneys than bombs

I was quoted as having said that to Marco della Cava, the USA Today reporter who wrote about the first kidney exchange between Israel and the UAE.

“Better to exchange kidneys than bombs,” says Roth, adding that using computers to search the world for medical solutions radically increases the chances of patients getting help. “International boundaries are artificial markers. Kidney disease doesn’t care about that.”

Thursday, September 30, 2021 Kidney Exchange between Israel and the UAE (in USA Today, yesterday)

How three Jewish and Arab families swapped kidneys, saved their mothers and made history by Marco della Cava, USA TODAY, Wed, September 29, 2021 AM