Liver exchange--a review by Agrawal, Gupta and Saigal

 

 Here's a review of liver exchange in the transplant literature, with some comparisons to kidney exchange.

Paired exchange Living donor Liver Transplantation: Indications, stumbling blocks, and future considerations by Dhiraj Agrawal, Subhash Gupta,  and Sanjiv Saigal, Journal of Hepatology, In Press,  Pre-proof https://doi.org/10.1016/j.jhep.2022.10.019 

Abstract: "The last decade has seen Liver Paired exchange (LPE) as an increasingly used modality across the transplant community by which pairs of incompatible living Liver donors and their intended recipients swap Livers resulting in compatible transplants. The feasibility and benefit of LPE in providing excellent recipient outcomes and robust donor safety have been proven in uncomplicated swaps. Began initially as single-centre two-way or three-way exchanges, LPE has tremendous potential to grow into more complicated chains over days and over multiple centres. Also, LPE is associated with unique technical, logistical, ethical and legislative challenges. This review discusses the indications, potential types of LPE, unique solutions to stumbling blocks in performing LPE, and future considerations on how LPE can expand the living donor liver pool and the armamentarium of living donor liver transplantation (LDLT)".

"The published literature on LPE has nine reports (5 original articles and 4 case reports), including 74 LPEs from Asia and North America.1), 2), 3), 4), 5), 6), 7), 8), 9) LPE constitutes approximately 1.2 to 8.3 % of the total LDLTs performed at the individual centre1), 2), 3), 4), signifying a substantial potential of this form of LDLT to mitigate the liver allograft shortage."

...

1. D. Agrawal, S. Saigal, S.S. Jadaun, S.A. Singh, S. Agrawal, S. Gupta

Paired Exchange Living Donor Liver Transplantation: A Nine-year Experience From North India

Transplantation (2022 Jun 30), 10.1097/TP.0000000000004210

Epub ahead of print. PMID: 35777310

 View PDF

Google Scholar

2)

S. Hwang, S.G. Lee, D.B. Moon, G.W. Song, C.S. Ahn, K.H. Kim, et al.

Exchange living donor liver transplantation to overcome ABO incompatibility in adult patients

Liver Transpl, 16 (4) (2010 Apr), pp. 482-490, 10.1002/lt.22017

PMID: 20222052

 View PDF

View Record in ScopusGoogle Scholar

3)

D.H. Jung, S. Hwang, C.S. Ahn, K.H. Kim, D.B. Moon, S.G. Lee, et al.

Section 16. Update on experience in paired-exchange donors in living donor liver transplantation for adult patients at ASAN Medical Center

Transplantation, 97 (Suppl 8) (2014 Apr 27), pp. S66-S69, 10.1097/01.tp.0000446280.81922.bb

PMID: 24849838

 View PDF

View Record in ScopusGoogle Scholar

4)

V. Gunabushanam, S. Ganesh, K. Soltys, G. Mazariegos, A. Ganoza, M. Molinari, et al.

Increasing Living Donor Liver Transplantation Using Liver Paired Exchange

J Am Coll Surg, 234 (2) (2022 Feb 1), pp. 115-120, 10.1097/XCS.0000000000000036

PMID: 35213430

 View PDF

View Record in ScopusGoogle Scholar

5)

A. Kaplan, R. Rosenblatt, W. Jackson, B. Samstein, R.S. Brown Jr.

Practices and Perceptions of Living Donor Liver Transplantation, Non-directed Donation, and Liver Paired Exchange: A National Survey

Liver Transpl, 28 (5) (2022 May), pp. 774-781, 10.1002/lt.26384

Epub 2021 Dec 26. PMID: 34862704; PMCID: PMC9018478

 View PDF

View Record in ScopusGoogle Scholar

6)

H.J. Braun, A.M. Torres, F. Louie, S.D. Weinberg, S.M. Kang, N.L. Ascher, et al.

Expanding living donor liver transplantation: Report of first US living donor liver transplant chain

Am J Transplant, 21 (4) (2021 Apr), pp. 1633-1636, 10.1111/ajt.16396

Epub 2020 Dec 8. PMID: 33171017; PMCID: PMC8016700

 View PDF

This article is free to access.

View Record in ScopusGoogle Scholar

7)

M.S. Patel, Z. Mohamed, A. Ghanekar, G. Sapisochin, I. McGilvray, N. Selzner, et al.

Living donor liver paired exchange: A North American first

Am J Transplant, 21 (1) (2021 Jan), pp. 400-404, 10.1111/ajt.16137

Epub 2020 Jul 10. PMID: 32524750

 View PDF

This article is free to access.

View Record in ScopusGoogle Scholar

8)

S.C. Chan, C.M. Lo, B.H. Yong, W.J. Tsui, K.K. Ng, S.T. Fan

Paired donor interchange to avoid ABO-incompatible living donor liver transplantation

Liver Transpl, 16 (4) (2010 Apr), pp. 478-481, 10.1002/lt.21970

PMID: 20373459

 View PDF

View Record in ScopusGoogle Scholar

9)

S.C. Chan, Chok KSh, W.W. Sharr, A.C. Chan, S.H. Tsang, W.C. Dai, et al.

Samaritan donor interchange in living donor liver transplantation

Hepatobiliary Pancreat Dis Int, 13 (1) (2014 Feb), pp. 105-109, 10.1016/s1499-3872(14)60016-3

PMID: 24463089

ArticleDownload PDFView Record in ScopusGoogle Scholar

NBER Market Design Working Group Meeting, Fall 2022, at Stanford, today and tomorrow

 While I'm away, the NBER Market Design meeting will convene at Stanford today and tomorrow.  The first paper is presented by Alex Chan (who you could hire, he's on the market).

Market Design Working Group Meeting, Fall 2022  November 4-5, 2022 (US Pacific Time) (more papers are linked at the above link and all presentations will be livestreamed on YouTube at https://www.youtube.com/nbervideos)

LOCATION Stanford University Graduate School of Business, Vidalakis Dining Hall, Schwab Residential Center, 680 Jane Stanford Way, Stanford, CA and YouTube 

ORGANIZERS Eric Budish, Jakub Kastl, and Marzena Rostek

 NBER conferences are by invitation. All participants are expected to comply with the NBER's Conference Code of Conduct.

Friday, November 4

Session 1. Matching Markets

9:00 am

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

Measuring the Welfare Gains from Cardinal-Preference Mechanisms in School Choice(slides)  by Hulya Eraslan, Rice University and NBER by Jeremy T. Fox, Rice University and NBER, YingHua He, Rice University, Yakym Pirozhenko, Rice University

10:20 am Coffee Break

Session 2. Markets and Algorithms

11:00 am Market Opacity and Fragility by Giovanni Cespa, City University London, Xavier Vives, IESE Business School

Artificial Intelligence and Pricing: The Impact of Algorithm Design by John Asker, University of California, Los Angeles and NBER Chaim Fershtman, Tel Aviv University, Ariel Pakes, Harvard University and NBER

12:20 pm  Lunch - Vidalakis Courtyard

Session 3: Young Scholars Session I: Financial Market Design

2:00 pm Intermediary Asset Pricing: Capital Constraints and Market Power(slides), Jason Allen, Bank of Canada, Milena Wittwer, Boston College

Endogenous Market Structure: Over-the-Counter versus Exchange Trading by Ji Hee Yoon, University College London

3:20 pm Coffee Break

Session 4: Young Scholars Session II: Market Design Theory

4:00 pm Strategyproofness-Exposing Mechanism Descriptions, by Yannai A. Gonczarowski, Harvard University, Ori Heffetz, Cornell University and NBER, and Clayton Thomas, Princeton University

Matching and Prices by Ravi Jagadeesan, Stanford University, Alexander Teytelboym, University of Oxford

Saturday, November 5

Session 5. Non-Market Allocation Mechanisms

9:00 am Optimal Queue Design by Yeon-Koo Che, Columbia University, Olivier Tercieux, Paris School of Economics

Fraud-proof Non-market Allocation Mechanisms by Eduardo Perez-Richet, Sciences Po, Vasiliki Skreta, UT Austin & UCL

10:20 am Coffee Break

Session 6. Environment and Transportation

11:00 am Pollution Permits: Efficiency by Design by Marek Pycia, University of Zurich, Kyle Woodward, University of North Carolina

Optimal Urban Transportation Policy: Evidence from Chicago(slides) by Milena Almagro, University of Chicago, Felipe Barbieri, University of Pennsylvania, Juan Camilo Castillo, University of Pennsylvania, Nathaniel G. Hickok, Massachusetts Institute of Technology, Tobias Salz, Massachusetts Institute of Technology and NBER

12:20 pm Lunch - Vidalakis Courtyard

Session 7. Auctions and Mechanism Design

This session: 25 minutes presenter, 5 minutes Q&A.

1:30 pm Screening with Persuasion by Dirk Bergemann, Yale University, , Tibor Heumann, PUC Chile, Stephen Morris, Massachusetts Institute of Technology

Auctions with Frictions by Stephan Lauermann, University of Bonn, Asher Wolinsky, Northwestern University

Pure-Strategy Equilibrium in the Generalized First-Price Auction, by Michael Ostrovsky, Stanford University and NBER, Andrzej Skrzypacz, Stanford University

Hervé Moulin is celebrated in Paris

 I'm in Paris to speak tomorrow at a ceremony and conference in honor of Hervé Moulin.  

A focus of the talks will be Moulin's work on fairness, and my talk (on controversial markets) will focus in part on how concern for possible unfairness of market outcomes may lead to attempts to ban certain markets.

Here's the announcement of the Friday session:

Cérémonie de clôture de la chaire d’excellence internationale Blaise Bascal [Closing ceremony of the Blaise Bascal Chair of International Excellence]

Vendredi 4 novembre 2022, amphithéâtre Liard en Sorbonne – 14 h à 19 h 30 17 rue de la Sorbonne

Programme

13 h 30 – 14 h : Accueil du public au 17, rue de la Sorbonne – 75005 Paris 

14 h – 14 h 05 : Ouverture de la cérémonie de clôture de la Chaire d’excellence internationale Blaise Bascal par Christine Neau-Leduc, présidente de l’université Paris 1 Panthéon-Sorbonne 

14 h 05 – 14 h 10 : Remerciements de Hervé Moulin, professeur à l’université de Glasgow 

14 h 10 – 15 h : Can we define Fairness? par Hervé Moulin 

15 h – 15 h 45 :  Repugnant Transactions and Controversial Markets par Alvin Roth 

15 h 45 – 16 h 45 : Pause  

16 h 15 –  17 h :  Democracy and the Pursuit of Randomness par Ariel Procaccia 

17 h – 17 h 45 : Fair Social Choice par Marc Fleurbaey 

17 h 45 – 17 h 55 : Discours de clôture par : 

Un représentant de la Région Ile-de-France 

Michel Grabisch, professeur à l’université Paris 1 Panthéon-Sorbonne 

Agnieszka Rusinowska, professeur à l’université Paris 1 Panthéon-Sorbonne 

*********

The following day (Saturday) will be a conference on 

Recent Advances in Fair Division November 5th, 2022, Université Paris I Panthéon-Sorbonne, Centre Panthéon, Salle 1

8:45-9:00 Welcome to participantso

9:00-9:45 :Haris Aziz, Best of Both Worlds Fairness

9:45-10:30 :Edith Elkind, Mind the Gap: Fair Division with Separation Constraints

10:30-11:00 Coffee 

11:30-12:15 :Juan D Moreno Ternero, The Costs and Benefits of multilingualism

12:15-13:00 :Jean-Jacques Herings, An Axiomatization of the Pairwise Netting Proportional Rule in Financial Networks

13:00-14:00 Lunch

14:00-14:45 :Dominik Peters, Voting in Participatory Budgeting

14:45-15:30 :Rupert Freeman, )A New Fairness Criterion for Assignment Mechanisms

15:30-16:00 Coffee break

16:00-16:45 :Utku Unver, Balancing Affirmative Action with Other Societal Interests:  a generalized theory on India’s reservation system

16:45-17:30 :Jean-Francois Laslier, Universalization and Altruism

Managing inter-district school choice, by Yuchiro Kamada and Fuhito Kojima

 Here's a paper that considers inter-district school choice, motivated by Tokyo day care centers.  I think  a similar problem arises in the EU in allocating foreign study opportunities for college students.

 Ekkyo Matching: How To Connect Separate Matching Markets For Welfare Improvement  By Yuichiro Kamada And Fuhito Kojima

Abstract. "We consider a school-choice matching model that allows for inter-district transfer of students, with the “balancedness” constraint: each student and school belongs to a region, and a matching is said to be balanced if, for each region, the outflow of students from that region to other regions is equal to the inflow of students from the latter to the former. Using a directed bipartite graph defined on students and schools, we characterize the set of Pareto efficient matchings among those that are individually rational, balanced and fair. We also provide a polynomial-time algorithm to compute such matchings. The outcome of this algorithm weakly improves student welfare upon the one induced when each region independently organizes a standard matching mechanism"

" In Japan ... allocation of slots at accredited daycares are conducted by individual municipal governments and, with few exceptions, a child can only attend a daycare in the municipality of their residence. The City of Tokyo, for example, is divided into 23 small municipalities ... and each conducts a matching independently. Due to the small sizes of the regions, many families would find inter-district admissions—which is called the ekkyo admission ... to be a viable option. Moreover, as a large metropolitan area, many people cross a city boundary to commute, making it potentially more convenient to put their children to a daycare center close to their workplace"

Affirmative action at Harvard and elsewhere, by Roland Fryer

 As the Supreme Court starts to hear arguments about affirmative action in college admissions, at Harvard and the University of North Carolina, Roland Fryer, a Black professor of Economics at Harvard, shares some thoughts--including stories from his own experience--about how affirmative action might be reformed.

Affirmative action in college admissions doesn’t work — but it could, By Roland G. Fryer Jr.,  Washington Post.

"On Monday, the Supreme Court will hear oral arguments in an affirmative action case involving Harvard, where I am a professor. Many people who are concerned about racial representation at elite institutions fear that the justices will end the practice as we know it. But if they do, they could provide an opportunity to create a new, data-based system that would truly help level the playing field for disadvantaged kids.

"I was raised, in part, by my father, who was sentenced to eight years in prison when I was in my teens. 

...

"But for my college professors’ willingness to look beyond my past performance — but for affirmative action — I would not have benefited from twice-weekly 7 a.m. meetings with the economics professor who showed me how science could be used to help people. Or the statistics professor who marveled at my stories of my favorite uncle — a wino with sophisticated strategies of betting on Greyhound races — and helped me use formal models to explain his behavior. Or a spot at the American Economic Association’s summer school for minority students.

"But affirmative action is very often not targeted at individuals who, because of disadvantage, are achieving below their potential. Seventy-one percent of Harvard’s Black and Hispanic students come from wealthy backgrounds. A tiny fraction attended underperforming public high schools. First- and second-generation African immigrants, despite constituting only about 10 percent of the U.S. Black population, make up about 41 percent of all Black students in the Ivy League, and Black immigrants are wealthier and better educated than many native-born Black Americans.

...

"The Supreme Court seems poised to strike down the explicit use of race in university admissions. My hope is that it will still leave room for data-driven approaches to affirmative action that ensure real meritocracy."

Unraveling of the market for new law professors

 Kim Krawiec, a law professor who is among the most penetrating analysts of controversial markets and market practices, emails me about unraveling in the market for new law professors:

"prior to Covid, the AALS (American Association of Law Schools) ran a hiring process with a central meeting in Washington DC and nearly every law professor was hired through this process. During Covid, this of course stopped and has now been dropped (I think) permanently, so now schools are sort of making up their own schedules. Some schools are starting early and making exploding offers before other schools have even begun the process. The idea of exploding offers is not new — it happened before. Though some (mostly higher ranked schools) considered it bad form, other schools argued that they had to do it or would wind up hiring no one year after year as favored candidates accepted other jobs near the end of the season. But the physical meeting and control over the timing by the AALS at least posed a basic schedule. That now appears to be gone and people (both candidates and hiring committees) are up in arms. ... My guess (completely speculating) is that the interests of higher ranked and lower ranked schools are not aligned on this and that makes it harder to find a new equilibrium, but I don’t know."

*******

Law already 'enjoys' a number of unraveled markets, for law clerks, for associates (and summer associates) in law firms, and for articles in law reviews.  So I have to admit the prospects for preventing wholesale unraveling of the law professor market looks bleak, unless law schools can start to think outside of the box, perhaps e.g. by preparing to give offers to students who have already accepted exploding offers, if necessary to start in the following academic year...  

Maybe in that way the academic law community can start to come to some agreement on some  time, midway between early and late, in which offers should be made and during which they should be left open.

2022 Exeter Prize to Sandro Ambuehl, Douglas Bernheim, and Axel Ockenfels

 Here's an announcement in an email from the Economic Science Association (ESA):

"We are happy to announce the winners of the 2022 Exeter Prize for the best paper published in the previous calendar year in a peer-reviewed journal in the fields of Experimental Economics, Behavioural Economics and Decision Theory.

The winners are Sandro Ambuehl (University of Zurich), Douglas Bernheim (Stanford University), and Axel Ockenfels (University of Cologne) for their paper “What motivates paternalism? An experimental study”, published in The American Economic Review. 

There is a growing interest in how “choice architects” design choices for others.  This paper provides new insights about how and why people in the role of a choice architect limit the decisions of others.  Ambuehl, Bernheim and Ockenfels use the tools of experimental economics to study how subjects help other subjects (“choosers”) to be more patient in tempting intertemporal choices (in which a small, immediate outcome is pitted against a large, delayed outcome).  A key result is that choice architects do act to restrict the choice set of choosers to help them avoid temptation.  A key strength the paper is offering insight into the motivations behind this decision.  The paper proposes and tests two possible motivations:  1) A “mistakes-projective paternalism” in which the choice architect assumes others share his/her susceptibilities to temptations and uses choice sets to minimize temptations and 2) an “ideals-projective paternalism” in which the choice architect assumes others follow his/her values and limit the choice set to those valued outcomes.  The results provide clear evidence for the latter motivation.  The paper provides evidence about additional beliefs and motivations.  Choice architects believe that they are improving the welfare of choosers and they underestimate how many people they are affecting with their restrictions.  Finally, the behavior of choice architects in the laboratory predicts support for real-world paternalistic policies (regarding, for example, taxes on alcohol and tobacco) and the motivation to make choices harder is consistent with “ideals-projective paternalism.”

The winning paper was selected by the panel of Rick Larrick (Duke University), Muriel Niederle (Stanford University), and Tomasz Strzalecki (Harvard University)."

 

The end of anonymous sperm donation...

 In  Colorado, a new law ending anonymous sperm donation seeks to catch up with the technological developments involving genetic sequencing that have already made anonymity of sperm or egg donors fairly fragile. Here's an account in JAMA:

The End of Anonymous Sperm Donation in Colorado--A Step Forward to a New Fertility Future in the US?  by I. Glenn Cohen, JD1; Eli Y. Adashi, MD, MS2; Seema Mohapatra, JD, MPH3   JAMA. Published online October 24, 2022. doi:10.1001/jama.2022.19471

"On May 31, 2022, Colorado became the first state to effectively ban anonymous gamete donation.1 Starting in 2025, fertility clinics in Colorado must collect identity and medical information from sperm and egg donors and may not match donors that do not agree to such disclosure (the statute uses the word “donor” though in many instances compensation is provided). The new law also requires that the clinics make a request that donors update their contact information and medical history at least once every 3 years. The law provides that a donor-conceived person aged 18 years or older shall be provided donor information upon request. The statute purports to also prohibit fertility clinics outside Colorado from providing gametes to Colorado residents (or individuals located in Colorado) if they do not abide by these rules. The statute also instructs clinics not to match a donor once it is known or reasonably should be known that “25 families have been established using a single donor in or outside of Colorado.”1

...

"Two states, Utah and Washington, have enacted statutes requiring the collecting and sharing of identifying information about a donor with donor-conceived children who request it after reaching the age of 18 years.3 However, both states also permit a donor to opt out, thereby limiting the utility of the laws. By contrast, the UK, Germany, Sweden, France, and many other countries have created mandatory registries that donor-conceived individuals can access when they turn 18 years of age, having an effect similar to the new Colorado law.3,4

"The new Colorado law highlights the gap between the law and reality of gamete donor anonymity in the US outside Colorado. Banks have promised donors anonymity in other US states and prior leaks of donor information from banks’ files have been exceedingly rare, if they ever happened at all; the banks have litigated to protect the identifying information provided by the donor.3 But in a practical sense, the promise of anonymity is now much less thoroughgoing.4 Direct-to-consumer genetic testing has become very common, and it has been estimated that 100 million people worldwide have taken a direct-to-consumer genetic test by 2021.4 Studies estimate that a genetic database covering only 2% of the population could match nearly anyone in that population.4 The combination of direct-to-consumer genetic testing, publicly available information, and social media suggest that many donor-conceived individuals will in fact be able to reidentify their gamete donor."

Surrogacy during wartime in Ukraine

 Surrogacy goes on amidst the war in Ukraine. The NYT has the story:

How Ukraine’s Surrogate Mothers Have Survived the War. When Russia invaded, Ukraine’s once-booming surrogacy industry seemed at risk of collapsing. But surrogate mothers and agencies have managed to continue deliveries, and clients are arriving again to pick up their children. By Maria Varenikova and Andrew E. Kramer

"Before Russia invaded in February, Ukraine was a major provider of surrogacy, one of the few countries that allows it for foreign clients. After a pause in the spring, surrogacy agencies are resuming their work, reviving an industry that many childless people rely on but that critics have called exploitative and that, in peacetime, was already ethically and logistically complex.

...

"Agencies are also adapting to the war. Besides helping surrogate mothers and their families relocate to safer cities, some have had to come up with ways to care for children as their biological parents struggled to overcome wartime and pandemic hurdles to reach Ukraine. Svitlana Burkovska, the owner of one small agency, Ferta, took infants into her own home for months.

...

"“We did not lose a single one,” said Ihor Pechenoha, the medical director at BioTexCom, Ukraine’s largest surrogacy agency and clinic. “We managed to bring all our surrogate mothers out from under occupation and shelling.”

...

"In the first month of the war, 19 babies born to surrogate mothers for one agency were marooned in a basement nursery in Kyiv. For weeks and months, it was difficult or impossible for biological parents to reach their children in Ukraine, but by August, all of the babies had gone home.

"The war has not diminished the appeal of surrogacy for couples desperate to have children, said Albert Tochylovsky, the director of BioTexCom.

...

"Before the war, the business thrived in Ukraine, where surrogate mothers typically earn about $20,000 per child they deliver. The war has made financial security even more urgent.

One 30-year-old surrogate mother, who spoke on the condition of anonymity because she had evacuated from Melitopol in Russia-occupied southern Ukraine and feared she could be targeted for reprisal, said she credited the job with getting her family out. “With the help of surrogacy,” she said, “I saved my family.”

"Owing to the nine-month lead time, agencies cannot make snap decisions about continuing or halting the business after developments like last week’s flurry of missile strikes, and pregnant mothers cannot be moved to jurisdictions outside Ukraine that do not recognize custody for biological parents in surrogate births.

Helping government workers ask for organ donor registration, by House, Lacetera, Macis, and Mazar

 Market designers can operate at every level of detail. Here's an experiment on promoting organ donor registration:

Nudging the Nudger: A Field Experiment on the Effect of Performance Feedback to Service Agents on Increasing Organ Donor Registrations by Julian House, Nicola Lacetera, Mario Macis & Nina Mazar, NBER WORKING PAPER 30547, DOI 10.3386/w30547, October 2022

Abstract: We conducted a randomized controlled trial involving nearly 700 customer-service representatives (CSRs) in a Canadian government service agency to study whether providing CSRs with performance feedback with or without peer comparison affected their subsequent organ donor registration rates. Despite having no tie to remuneration or promotion, the provision of individual performance feedback three times over one year resulted in a 25% increase in daily signups, compared to otherwise similar encouragement and reminders. Adding benchmark information that compared CSRs performance to average and top peer performance did not further enhance this effect. Registrations increased more among CSRs whose performance was already above average, and there was no negative effect on lower-performing CSRs. A post-intervention survey showed that CSRs found the information included in the treatments helpful and encouraging. However, performance feedback without benchmark information increased perceived pressure to perform.

"We collaborated with ServiceOntario, an agency of the Ministry of Government and Consumer Services. The agency provides a single point of contact for most government services in the province (e.g., driver and vehicle licensing, license plate stickers, public health insurance registration, and business licensing). Most of the organ registrations in Ontario (pre-Covid-19 pandemic: 85%, Trillium Gift of Life Network, 2017) have occurred with customers visiting ServiceOntario centers in person.3 Because of their unique role, ServiceOntario customer-service representatives (CSRs) are ideally positioned to promote organ donor registrations when interacting with citizens. Indeed, operational policy instructs them to implement a prompted-choice procedure with all customers. "

Kidney exchange collaboration between Stanford and APKD

 I recently had occasion to review the long collaboration between my Stanford colleagues and Mike Rees and the Alliance for Paired Kidney Donation. It turns out that, together with other coauthors, Mike and his APKD colleagues have written well over a dozen papers with me and my colleagues at Stanford.  (My own collaboration with Mike and APKD goes back to when Itai Ashlagi and I were still in Boston, where my earliest papers on kidney exchange were with  Tayfun Sönmez and Utku Ünver, and with Frank Delmonico and his colleagues at the New England Program for Kidney Exchange.)

Here's the list I came up with, probably not exhaustive:

Mike Rees/APKD collaborations with Stanford scholars (Ashlagi, Melcher, Roth, Somaini)

 1. Rees, Michael A., Jonathan E. Kopke, Ronald P. Pelletier, Dorry L. Segev, Matthew E. Rutter, Alfredo J. Fabrega, Jeffrey Rogers, Oleh G. Pankewycz, Janet Hiller, Alvin E. Roth, Tuomas Sandholm, Utku Ünver, and Robert A. Montgomery, “A Non-Simultaneous Extended Altruistic Donor Chain,” New England Journal of Medicine, 360;11, March 12, 2009, 1096-1101. https://www.nejm.org/doi/full/10.1056/NEJMoa0803645

2.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “Nonsimultaneous Chains and Dominos in Kidney Paired Donation – Revisited,” American Journal of Transplantation, 11, 5, May 2011, 984-994 http://www.stanford.edu/~alroth/papers/Nonsimultaneous%20Chains%20AJT%202011.pdf

3.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “NEAD Chains in Transplantation,” American Journal of Transplantation, December 2011; 11: 2780–2781. http://web.stanford.edu/~iashlagi/papers/NeadChains2.pdf

4.     Wallis, C. Bradley, Kannan P. Samy, Alvin E. Roth, and Michael A. Rees, “Kidney Paired Donation,” Nephrology Dialysis Transplantation, July 2011, 26 (7): 2091-2099 (published online March 31, 2011; doi: 10.1093/ndt/gfr155, https://academic.oup.com/ndt/article/26/7/2091/1896342/Kidney-paired-donation

5.     Rees, Michael A.,  Mark A. Schnitzler, Edward Zavala, James A. Cutler,  Alvin E. Roth, F. Dennis Irwin, Stephen W. Crawford,and Alan B.  Leichtman, “Call to Develop a Standard Acquisition Charge Model for Kidney Paired Donation,” American Journal of Transplantation, 2012, 12, 6 (June), 1392-1397. (published online 9 April 2012 http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2012.04034.x/abstract )

6.     Anderson, Ross, Itai Ashlagi, David Gamarnik, Michael Rees, Alvin E. Roth, Tayfun Sönmez and M. Utku Ünver, " Kidney Exchange and the Alliance for Paired Donation: Operations Research Changes the Way Kidneys are Transplanted," Edelman Award Competition, Interfaces, 2015, 45(1), pp. 26–42. http://pubsonline.informs.org/doi/pdf/10.1287/inte.2014.0766

7.     Fumo, D.E., V. Kapoor, L.J. Reece, S.M. Stepkowski,J.E. Kopke, S.E. Rees, C. Smith, A.E. Roth, A.B. Leichtman, M.A. Rees, “Improving matching strategies in kidney paired donation: the 7-year evolution of a web based virtual matching system,” American Journal of Transplantation, October 2015, 15(10), 2646-2654 http://onlinelibrary.wiley.com/enhanced/doi/10.1111/ajt.13337/ (designated one of 10 “best of AJT 2015”)

8.     Melcher, Marc L., John P. Roberts, Alan B. Leichtman, Alvin E. Roth, and Michael A. Rees, “Utilization of Deceased Donor Kidneys to Initiate Living Donor Chains,” American Journal of Transplantation, 16, 5, May 2016, 1367–1370. http://onlinelibrary.wiley.com/doi/10.1111/ajt.13740/full

9.     Michael A. Rees, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Alejandra Cicero, Laurie J. Reece, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Samay Jain, Miguel Tan and Siegfredo R. Paloyo, “Kidney Exchange to Overcome Financial Barriers to Kidney Transplantation,” American Journal of Transplantation, 17, 3, March 2017, 782–790. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14106/full  

a.     M. A. Rees, S. R. Paloyo, A. E. Roth, K. D. Krawiec, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, “Global Kidney Exchange: Financially Incompatible Pairs Are Not Transplantable Compatible Pairs,” American Journal of Transplantation, 17, 10, October 2017, 2743–2744. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14451/full

b.     A. E. Roth, K. D. Krawiec, S. Paloyo, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, and M. A. Rees, “People should not be banned from transplantation only because of their country of origin,” American Journal of Transplantation, 17, 10, October 2017, 2747-2748. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14485/full

c.      Ignazio R. Marino, Alvin E. Roth, Michael A. Rees; Cataldo Doria, “Open dialogue between professionals with different opinions builds the best policy, American Journal of Transplantation, 17, 10, October 2017, 2749. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14484/full

10.  Danielle Bozek, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Laura Basagoitia, Robert J. Brunner, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Puneet Sindhwani, Jorge Ortiz, Miguel Tan, and Siegfredo R. Paloyo, Michael A. Rees, “The Complete Chain of the First Global Kidney Exchange Transplant and 3-yr Follow-up,” European Urology Focus, 4, 2, March 2018, 190-197. https://www.sciencedirect.com/science/article/pii/S2405456918301871

11.  Itai Ashlagi, Adam Bingaman, Maximilien Burq, Vahideh Manshadi, David Gamarnik, Cathi Murphey, Alvin E. Roth,  Marc L. Melcher, Michael A. Rees, ”The effect of match-run frequencies on the number of transplants and waiting times in kidney exchange,” American Journal of Transplantation, 18, 5, May 2018,  1177-1186, https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.14566

12.   Stepkowski, S. M., Mierzejewska, B., Fumo, D., Bekbolsynov, D., Khuder, S., Baum, C. E., Brunner, R. J., Kopke, J. E., Rees, S. E., Smith, C. E., Ashlagi, I., Roth, A. E., Rees, M. A., “The 6-year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program- a retrospective study,” Transplant international 32: 839-853. 2019. https://onlinelibrary.wiley.com/doi/10.1111/tri.13423

13.   Roth, Alvin E., Ignazio R. Marino, Obi Ekwenna, Ty B. Dunn, Siegfredo R. Paloyo, Miguel Tan, Ricardo Correa-Rotter, Christian S. Kuhr, Christopher L. Marsh, Jorge Ortiz, Giuliano Testa, Puneet Sindhwani, Dorry L. Segev, Jeffrey Rogers, Jeffrey D. Punch, Rachel C. Forbes, Michael A. Zimmerman, Matthew J. Ellis, Aparna Rege, Laura Basagoitia, Kimberly D. Krawiec, and Michael A. Rees, “Global Kidney Exchange Should Expand Wisely, Transplant International, September 2020, 33, 9,  985-988. https://onlinelibrary.wiley.com/doi/full/10.1111/tri.13656

14.  Vivek B. Kute, Himanshu V. Patel, Pranjal R. Modi, Sayyad J. Rizvi, Pankaj R. Shah, Divyesh P Engineer, Subho Banerjee, Hari Shankar Meshram, Bina P. Butala, Manisha P. Modi, Shruti Gandhi, Ansy H. Patel, Vineet V. Mishra, Alvin E. Roth, Jonathan E. Kopke, Michael A. Rees, “Non-simultaneous kidney exchange cycles in resource-restricted countries without non-directed donation,” Transplant International,  Volume 34, Issue 4, April 2021,  669-680  https://doi.org/10.1111/tri.13833

15.   Afshin Nikzad, Mohammad Akbarpour, Michael A. Rees, and Alvin E. Roth “Global Kidney Chains,” Proceedings of the National Academy of Sciences, September 7, 2021 118 (36) e2106652118; https://doi.org/10.1073/pnas.2106652118 .

16.    Alvin E. Roth, Ignazio R. Marino, Kimberly D. Krawiec, and Michael A. Rees, “Criminal, Legal, and Ethical Kidney Donation and Transplantation: A Conceptual Framework to Enable Innovation,” Transplant International  (2022), 35: doi: 10.3389/ti.2022.10551, https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10551/full

17.   Ignazio R. Marino, Alvin E. Roth, and Michael A. Rees, “Living Kidney Donor Transplantation and Global Kidney Exchange,” Experimental and Clinical Transplantation (2022), Suppl. 4, 5-9. http://www.ectrx.org/class/pdfPreview.php?year=2022&volume=20&issue=8&supplement=4&spage_number=5&makale_no=0

18.  Agarwal, Nikhil, Itai Ashlagi, Michael A. Rees, Paulo Somaini, and Daniel Waldinger. "Equilibrium allocations under alternative waitlist designs: Evidence from deceased donor kidneys." Econometrica 89, no. 1 (2021): 37-76.

And here’s a report of work in progress:

The First 52 Global Kidney Exchange Transplants: overcoming multiple barriers to transplantation by MA Rees, AE Roth , IR Marino, K Krawiec, A Agnihotri, S Rees, K Sweeney, S Paloyo, T Dunn, M Zimmerman, J Punch, R Sung, J Leventhal, A Alobaidli, F Aziz, E Mor, T Ashkenazi, I Ashlagi, M Ellis, A Rege, V Whittaker, R Forbes, C Marsh, C Kuhr, J Rogers, M Tan, L Basagoitia, R Correa-Rotter, S Anwar, F Citterio, J Romagnoli, and O Ekwenna.  Transplantation: September 2022 - Volume 106 - Issue 9S - p S469 doi: 10.1097/01.tp.0000887972.53388.77  https://journals.lww.com/transplantjournal/Fulltext/2022/09001/423_9__The_First_52_Global_Kidney_Exchange.697.aspx

Josh Morrison profiled in Vox

 Josh Morrison, the founder of WaitlistZero and 1DaySooner, is an unusually energetic and effective effective altruist.   

Here's a profile in Vox:

Josh Morrison took risks for science, and he thinks you can, too. From kidney donations to human challenge trials for Covid-19 vaccines, Josh Morrison shows the vast good any individual can do. By Muizz Akhtar

"Morrison first became familiar with this kind of direct public health participation when he read about kidney donations in the New Yorker when he was a law student in 2009. In the piece, people explained why they gave their kidneys to strangers in need — though there was slight risk to donors, the reward and benefit for the recipients was more than worth it. Two years later, he donated a kidney himself.

...

“The basic logic of my work in general is to try to use a sort of identity politics to get better political decision-making,” Morrison told me. “So with kidney donation, the theory is if kidney donors are more empowered in the political system as a sort of identity group, then the system will treat donors better and that will mean more people donate.”

HT: Frank McCormick

**********

I've mentioned Josh Morrison in many of my posts...

Informationally Simple Incentives by Simon Gleyze and Agathe Pernoud

 Agathe Pernoud is on the Economics job market from Stanford this year, and is interested in the properties of information in environments in which agents may need to learn their own preferences.

Here are two papers that advance the theory of those situations, and expand on the fragility of 'dominant strategies' as the strategy space is enlarged.

Informationally Simple Incentives by Simon Gleyze and Agathe Pernoud, Journal of Political Economy, forthcoming.

Abstract: We consider a mechanism design setting in which agents can acquire costly information on their preferences as well as others’. A mechanism is informationally simple if agents have no incentive to learn about others’ preferences. This property is of interest for two reasons: First, it is a necessary condition for the existence of dominant strategy equilibria in the extended game.  Second, this endogenizes an “independent private value” property of the interim information structure. We show that, generically, a mechanism is informationally simple if and only if it satisfies a separability condition which rules out most economically meaningful mechanisms."

See also Agathe's job market paper:

How Competition Shapes Information in Auctions by Simon Gleyze and Agathe Pernoud

We consider auctions where buyers can acquire costly information about their valuations and those of others, and investigate how competition between buyers shapes their learning incentives. In equilibrium, buyers find it cost-efficient to acquire some information about their competitors so as to only learn their valuations when they have a fair chance of winning. We show that such learning incentives make competition between buyers less effective: losing buyers often fail to learn their valuations precisely and, as a result, compete less aggressively for the good. This depresses revenue, which remains bounded away from the expected second-highest valuation even when information costs are small. It also undermines price discovery. Finally, we examine the implications for auction design. First, setting an optimal reserve price is more valuable than attracting an extra buyer. Second, the seller can incentivize buyers to learn their valuations, hence restoring effective competition, by maintaining uncertainty over the set of auction participants.

Reforming kidney care, by Drs. Ben Hippen and Thao Pascual.

 Ben Hippen is a transplant nephrologist who I encountered not too long after I started to think about kidney transplants. I've always found it enlightening to listen to him. And he's changed where he sits, most recently by taking a position with Fresenius, the big dialysis provider.

Here's a snippet of his professional history from his cv:

Current positions:

•Senior Vice President, Global Head of Transplant Medicine, Fresenius Medical Care. Sept 2021

•Clinical Professor of Internal Medicine, University of North Carolina, Chapel Hill School of Medicine. (Non-tenure track appointment) April 2015-present.

Past Positions:

•General and Transplant Nephrologist, Metrolina Nephrology Associates, P.A, Charlotte, North Carolina. 2005-2021

•Attending General and Transplant Nephrologist, Transplant Center, Carolinas Medical Center, Charlotte, North Carolina. 2005 - 2021

•Medical Director, FKC Baxter Street Hemodialysis Unit (in-center and home therapies).2009-2021.

Here are some of his current thoughts, with his colleague Dr. Pascual, in Medpage Today on how to advance kidney care and transplantation.

The Kidney Transplant Ecosystem Is Ripe for Reform— Here are the policies and payment systems that need to change  by Benjamin Hippen, MD, and Thao Pascual, MD

"A centralized data repository of patients' clinical evaluations, laboratory, and radiologic testing accessible by multiple transplant centers could reduce the time, expense, and waste of redundant or obsolete testing.

...

"Quality outcomes for transplant programs should be pegged to the patient outcome that really matters: Receiving a successful kidney transplant in the shortest period of time. A recent survey of patients with kidney disease regarding tradeoffs between being transplanted earlier and waiting for a "better organ" confirms that a wide majority of patients prioritize being transplanted sooner. "Transplant soon and well" should be the mantra for regulators and policy makers when considering nephrologist and dialysis provider-facing metrics to achieve the right outcomes for patients. 

...

"several reforms can be made to the transplant ecosystem to make it easier for transplant centers to be more aggressive in their organ acceptance behaviors. Changing the organ offer system to use the approach of "simultaneously expiring offers" can streamline organ placement timelines, placing higher-risk organs with more risk-tolerant centers more quickly and efficiently. Aligned with the goal of getting patients to transplant faster, regulators and payors (public and private) should prioritize shortening time to transplant over sky-high 1-year patient and graft survival thresholds. The lowest performing third of transplant centers are conferring longer and better survival rates to patients compared to any maintenance dialysis therapy. We should seek to remove regulatory and financial barriers to transplant centers seeking to safely make use of every gift of life. If we expect transplant centers to transplant higher-risk organs, we should recognize that it may cost more to perform those transplants successfully. The payment system for transplants should account for these higher costs so that transplant centers are not faced with losing money when transplanting higher-risk organs.

"A key component of the kidney transplant ecosystem is the generosity of living donors, and we should do more to support their decision to give the gift of life. This means protecting living donors from insurer efforts to exclude them from life or disability insurance coverage because of their donation. In addition, enhancing education efforts to increase living donor kidney transplants can help bridge the gap between organ need and supply. One pending solution to these challenges is the passage of the Living Donor Protection Act (H.R.1255/S.377). The bill would prohibit discrimination by insurers based on an individual's status as a living organ donor. Employers can also do their part through adjusting their paid leave policies for employees who become living donors, by joining the AST Living Donor Circle of Excellence."

"Benjamin Hippen, MD, is senior vice president and head of transplant medicine and emerging capabilities at Fresenius Medical Care. Thao Pascual, MD, is associate chief medical officer at U.S. Renal Care. They are both members of Kidney Care Partners."

********

As a long time, thoughtful  observer of kidney care and transplantation, Dr Hippen's point of view has shifted over time. Below are some (much) earlier blog posts featuring some of his earlier thoughts.

Wednesday, March 16, 2011

How not to assign kidneys

Saturday, April 9, 2011

Should there be a donor kidney market? Latest version of a familiar debate

Sunday, July 26, 2015

Ben Hippen on the economics of transplantation and dialysis

Privacy and data gathered by home devices

 Does your robot vacuum cleaner make a map of your house as it moves around, and store it on the web?  Could the fact that your kitchen chairs haven't moved all week allow someone to know that no one is home?  These are the kinds of things that people worry about when thinking of all the data collected by smart devices.

The Washington Post has this story:

Tour Amazon’s dream home, where every appliance is also a spy. Here’s everything Amazon learns about your family, your home and you.  by Geoffrey A. Fowler

"Echo speaker

"Echos respond to the wake word “Alexa” to summon the voice assistant to play music, answer questions, shop and control other devices.

"What it knows: Collects audio recordings through an always-on microphone; keeps voice IDs to differentiate users; detects coughs, barks, snores and other sounds; logs music and news consumption; logs smart-home device activity and temperature; detects presence of people though ultrasound.

"Ring doorbell

"What it knows: Live and recorded video, audio and photos of the outside of your house; when people come and go and you receive packages; status of linked devices like lights.

...

"Kindle or Fire Tablet

"What it knows: What and when you read and watch entertainment and news; when you open, close and how long you use third-party apps; your location.

"Why that matters: Amazon knows exactly how fast you read and how far you actually got through your last novel. Kindles and Fire Tablets are another way Amazon gets to know your tastes, which helps it sell you things.

...

"Roomba vacuum cleaner

"A vacuum cleaner that automatically roams around your house to clean, which Amazon is acquiring in a still-pending deal for $1.7 billion.

"What it knows: Camera identifies obstacles and layout of rooms and furniture; when, how often and where you clean.

"Why that matters: When the deal was announced, some Roomba owners balked at the idea that Amazon might gain access to maps of their home, created by the robots to help them clean. "

The past and future of the transition from medical school to residency, in the Journal of Graduate Medical Education, by Williamson, Soane, and Carmody

 The October issue of the Journal of Graduate Medical Education considers the past and future of the transition to residency.

The US Residency Match at 70: What Was, What Is, and What Could Be  by Edwin Williamson, MD; Caroline Soane, BA; J. Bryan Carmody, MD, MPH, J Grad Med Educ (2022) 14 (5): 519–521., https://doi.org/10.4300/JGME-D-22-00248.1

"But while early offers are long gone, the residency selection process now faces a new set of challenges related to the increasing number of applications submitted by contemporary applicants. In 2020 the average US medical school graduate submitted 70 residency applications.9  The average for some specialties is even higher. For instance, in 2022, the average osteopathic medical school applicant in obstetrics and gynecology submitted 85 applications, while US MD applicants in orthopedic surgery submitted 96 applications, and international medical graduates submitted 100 applications each to internal medicine programs.10  This overapplication increases costs for applicants and programs, leads to reliance on convenient screening metrics in applicant evaluation, and does not ultimately improve Match rates.9 "

School choice consulting in New York City

 It is a truth universally acknowledged that any stressful process in which affluent people participate must be in need of a consulting industry.

New York City's school choice processes are no exception:

The School-Admissions Whisperer Joyce Szuflita can assuage Brooklyn’s most anxious parents.  By Caitlin Moscatello

"For the better part of two decades, Szuflita has demystified the process of public-school admissions for some of Brooklyn’s most overwhelmed, optimization-prone parents. ... Prekindergarten and elementary admission are largely based on where you live. But the game gets significantly more byzantine come middle school and more complex yet for high school, with its tier of “screened” institutions that have traditionally required students to test in, audition, or undergo other high-stress assessments. The process of getting into certain schools — and don’t kid yourself, everybody wants in — has long been a brutal one. Until it got slightly easier. And then brutal again. Or maybe some middle level of brutal? This is why parents need Szuflita.

...

"On September 29, schools chancellor David C. Banks abruptly announced that some of the city’s most prestigious middle and high schools would move away from an open lottery system and increase their use of merit-based admissions. The approach prioritizes students with an A average — children Banks calls “hardworking,” a loaded description in a city with one of the greatest wealth disparities in the country — and reverses the previous mayor’s strategy, which aimed to usher more lower-income students into New York’s top schools.

...

“The pendulum is swinging back a little bit,” Szuflita says of the Banks announcement, insisting that the changes are not as sweeping as they might seem. “The algorithm is still exactly the same.” Contrary to how some have read the news, the old lottery is still partially in use. The random number (a hexadecimal, actually) that each student is assigned works as a tiebreaker to get into screened high schools and can sometimes be a major factor when families submit their ranked choices of preferred schools.

"Clients often panic about their lottery numbers and want to change the ranking of their list, which Szuflita doesn’t recommend for anyone except those with exceptionally high or low numbers. Trying to outsmart the process, she says, is pure “magical thinking.” She’s constantly telling parents to trust the fairness of the city’s sorting algorithm, whose authors literally won the Nobel Prize, and rank in true preference order. (Or, as she tends to put it in emails: “RANK IN TRUE PREFERENCE ORDER!!!!!!!”) Despite this, clients sometimes persist, asking, How do we work the algorithm to our advantage? How do we strategize ranking our list? “That’s when I yell at people in the nicest way,” she says, because they don’t know what they’re talking about and they’re cutting into her time. “Like, ‘No, shut up. Shut up and listen to me. You’re not going to get everything you need to know.’” But most of her consults take two hours, she says, and don’t involve a lot of back-and-forth. “They tell me about their children and then what follows is usually a rapid-fire, two-hour information dump from me. There is not a lot of airing of concerns, because I already anticipate their concerns.” The download is intensely specific, tailored to each family and covering individual schools, principals, teachers, and facility upgrades few people are aware of. She verifies rumors (or sets the record straight) and knows things you can’t find on the internet."

**********

Related recent post:

Sunday, October 2, 2022

Return to previous school assignment policies (in some respects) under New York City's new mayor