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."

####### 

 

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). 

Medical aid in dying to become available in New York State

 Here's the announcements from the New York State Governor's office:

Governor Hochul Reaches Agreement With State Legislature to Pass Medical Aid in Dying Act in New York  

"Governor Hochul today announced an agreement with the Legislature to make medical aid in dying available to terminally ill New Yorkers with less than six months to live. This comes after careful reflection and deliberation with the bill’s sponsors, advocacy organizations, and most importantly, everyday New Yorkers who shared personal experiences with the Governor. The bill, with the agreed-upon amendments, will be passed and signed in January, and the law will go into effect six months later.

“New York has long been a beacon of freedom, and now it is time we extend that freedom to terminally ill New Yorkers who want the right to die comfortably and on their own terms,” said Governor Hochul. “My mother died of ALS, and I am all too familiar with the pain of seeing someone you love suffer and being powerless to stop it. Although this was an incredibly difficult decision, I ultimately determined that with the additional guardrails agreed upon with the legislature, this bill would allow New Yorkers to suffer less–to shorten not their lives, but their deaths.”
 

"The bill, as passed by the Legislature, had a number of protections in place to ensure that no patient was coerced into utilizing medical aid in dying and no doctor or religiously affiliated health facility was forced to offer medical aid in dying. With today’s agreement, the Governor announces a number of additional guardrails that the Legislature has agreed to enact aimed at ensuring the integrity of the patient’s decision and the preparedness of medical institutions to appropriately administer medical aid in dying. Today’s agreement memorializes a shared path forward on this bill, with additional key guardrails, including:

    A mandatory waiting period of 5 days between when a prescription is written and filled.
    An oral request by the patient for medical aid in dying must be recorded by video or audio.
    A mandatory mental health evaluation of the patient seeking medical aid in dying by a psychologist or psychiatrist.
    A prohibition against anyone who may benefit financially from the death of a patient from being eligible to serve as a witness to the oral request or an interpreter for the patient.
    Limiting the availability of medical aid in dying to New York residents.
    Requiring that the initial evaluation of a patient by a physician be in person.
    Allowing religiously-oriented home hospice providers to opt out of offering medical aid in dying.
    Ensuring that a violation of the law is defined as professional misconduct under the Education Law.
    Extending the effective date of the bill to six months after signing to allow the Department of Health to put into place regulations required to implement the law while also ensuring that health care facilities can properly prepare and train staff for compliance."

 

Experimental math (XKCD)

The Unreasonable Effectiveness of Mathematics

 https://xkcd.com/3180/

 

Interview about the new edition of the Chinese translation of Who Gets What and Why

 Last month I was interviewed in connection with the new edition of the Chinese translation of my 2015 book Who Gets What and Why.  

Here is the interview in Chinese, and translated back to English. (You can also click "translate to English" from the Chinese version, to get a more creative translation that among other things renders my name as variations on "Erwin Ross.")

 Below are some excerpts from the better back-translation (from interview in English translated into Chinese, and then back to English):

"In November 2025, LatePost conducted a video interview with Roth. The interview began at 7 a.m. local time, and the 74-year-old had already arrived at his office, walking on a treadmill desk while conversing with us. A white beard, furrowed brow when deep in thought, a smiling expression, and concise communication—these are the impressions Roth gave during the conversation.

'Market design is economics confronting the external world,' Roth told us. A month earlier, his popular book on market design, Who Gets What―and Why, was republished in Chinese under the title Matching. Designing, improving, and maintaining well-functioning matching mechanisms is the work of market design. In Matching, Roth demonstrated how market design could be applied in practice to change people's destinies and the way societies operate. 

...

"Alvin Roth: Significant changes have occurred in both kidney transplantation and kidney exchange. By the way, since 2015, there has been a major transformation in the approach to transplant surgeries in China. Prior to that, most organs used in transplants came from executed prisoners; now, China is developing a voluntary organ donation program, which represents a significant shift. However, China has yet to initiate kidney exchange programs.

"A new global trend is that we are beginning to experiment with cross-border kidney exchanges. This is particularly crucial for smaller countries or regions with limited numbers of kidney transplants, where some patients struggle to find compatible donors. 

...

"Q: In your "Market Design" blog, you previewed a new book to be published next year titled Moral Economics: From Prostitution to Organ Sales, What Controversial Transactions Reveal About How Markets Work. Why did you write this book? What issues do you discuss and how do you address them?

"Alvin Roth: One issue that economists have yet to fully understand is which markets gain societal support and which ones do not. For instance, I have explored the surrogacy market. Surrogacy is legal in the United States but illegal in China. After the Chinese government relaxed its one-child policy, many people desired to have a second child, but age became an obstacle. In California, where I reside, there are agencies offering surrogacy services where Mandarin is spoken, and many clients come from China.

"This is one of the core questions I attempt to address: why are certain genuinely beneficial practices legal in some places but illegal in others? "

#######

When I search for the new edition on Google I get the following AI overview:

Alvin Roth's book, originally titled

Who Gets What―and Why: The New Economics of Matchmaking and Market Design, has been published in Chinese under two different titles. 

The two Chinese titles are:

• 《共享经济：市场设计及其应用》 (Simplified Chinese: Gòngxiǎng jīngjì: Shìchǎng shèjì jí qí yìngyòng, meaning "Sharing Economy: Market Design and Its Application").
• 《配对：诺奖得主艾文・罗斯教你赢得博弈，突破市场经济赛局的思维》 (Traditional Chinese: Pèiduì: Nuò jiǎng dé zhǔ Ài wén luō sī jiào nǐ yíng dé bó yì, tū pò shìchǎng jīngjì sài jú de sī wéi, meaning "Matching: Nobel Laureate Alvin Roth Teaches You to Win the Game and Break Through Market Economy Game Thinking"). 

The simplified Chinese characters edition was published by Machinery Industry Press in 2015. 

 

Earlier: 

Thursday, January 28, 2016  Who Gets What and Why in Chinese

 

 

Erik Brynjolfsson interviewed in Newsweek

 Always thought provoking: 

Centaurs, Canaries and J-Curves: Pitfalls and Productivity Potential of AI
By Marcus Weldon 

"Brynjolfsson occupies a unique position as both a Stanford University professor and the head of the digital economy lab at the Institute for Human Centered AI, which allows him the freedom to pursue analyses that are not compromised by a particular corporate or financial agenda, but are still grounded in economic reality and, at the same time, also account for the human part of the equation. Indeed, one of the primary conclusions of our conversation is that augmentation of human tasks is where the real economic gains are to be found, rather than in replacing human activity by automation, and consequently that, as he puts it, “We need to treat humans as an end and not just a means to an end.” But what is particularly striking is that this seemingly facile and human-validating imperative is anything but that: it is based on hard economic facts and rigorous analyses that are gradually revealed over the course of our conversation." 

 

The above link also takes you to this video: 

 

#########

Erik has been thinking about AI for a long time (even if not as long as the folks I posted about yesterday). 

Which trade organization is protecting its members from a real threat from AI?

Science fiction writers have long speculated on worlds in which humans coexist with intelligent robots.

And forewarned is forearmed. The Science Fiction and Fantasy Writers Association (SWFA) has taken steps to protect its members from large language models, in the context of awards for writing science fiction:

 "The following rules for the Nebula Awards® are effective starting with the award year beginning January 1, 2025:
...
    "Works that are written, either wholly or partially, by generative large language model (LLM) tools are not eligible.
    Works that used LLMs at any point during the writing process must disclose this upon acceptance of the nomination, and those works will be disqualified. "

###

Bonus cartoon:

 

Michel Callon (1945–2025): A life with passion for economies, in J. of Cultural Economy

Here's an appreciation of the great economic sociologist:

 Michel Callon (1945–2025): A life with passion for economies
Koray Caliskan &Alexandre Mallard, Journal of Cultural Economy, Published online: 15 Dec 2025 https://doi.org/10.1080/17530350.2025.2595423 

 "Readers of the Journal of Cultural Economy will likely remember Michel Callon for the remarkable line of inquiry into markets that he initiated in the 2000s. Yet to recall how he approached the economy throughout his intellectual journey – and how, in doing so, he transformed our very understanding of economies – is a good way to honor an intellectual beacon of our times."

 ########

Earlier:

Saturday, August 30, 2025 Michel Callon (1945-2025)

 

The market for used underwear, in the journal Genre, sexualité & société

 The study of repugnant transactions and controversial markets can lead to some strange markets.

 In the latest issue of the journal Genre, sexualité & société (after right clicking to translate to English) :

Product qualification in a contested market: The case of the used underwear market
by Ludine Cayla and Julien Gradoz
https://doi-org.stanford.idm.oclc.org/10.4000/154ww 

Abstract: This article focuses on the used underwear market, defined as the market for underwear that has been worn by one or more individuals and sold unwashed, meaning it contains deliberately left secretions and fluids. It distinguishes websites where the nature of the product sold must be concealed (such as resale websites for secondhand items) due to the prohibition of the transactions, and websites where the product can be openly discussed (such as websites specializing in the sale of sexual items). This distinction allows for the study of the issue of product qualification and disqualification in a contested market, which has been hardly explored. More broadly, this article helps identify the main characteristics of an overlooked market that, until now, has only been the subject of sensationalist analyses. 

"this is a "contested market," that is, a market in which some people would like to carry out transactions, but third parties oppose them on the basis of moral considerations. This opposition can then translate into constraints placed on the organization of the market (Roth, 2007), such as its prohibition (e.g., organs), the prohibition of advertising (cigarettes), difficulties in obtaining a bank loan (pornography), the imposition of punitive taxes (sodas), or even the stigmatization of participants in the transactions. Contested markets have been the subject of a substantial body of literature over the past decade (e.g., Steiner and Trespeuch, 2014; Bertrand et al ., 2020; Bertrand and Panitch, 2024; Gradoz and Dekker, 2025), and this article proposes to analyze the used underwear market based on this literature, moving beyond the sensationalism that has prevailed until now. This literature has focused in particular on the justifications used by third parties to challenge the existence of certain markets, or on the strategies implemented by participants in transactions to cope with the constraints resulting from this challenge." 

Navigating congested (dating) markets: Judd Kessler's advice for the frustrated

 Pessimistic about dating? Harvard-trained economist says do 2 simple things to improve your luck
by Judd B. Kessler

 1. Ditch the disinterested
Aggressively screen out people based on their interest in you.  

...

"2. Lean into idiosyncratic preferences
Identify what you — and specifically you — desire in a partner. What do you particularly value that may not be commonly desired by others? Economists call these your idiosyncratic preferences, distinguishing them from general preferences that are more commonly held. 

...

"And since people are looking for idiosyncrasies, you should advertise yours, too. Let potential daters know about your quirks (the kind that attract some people while repelling others) on your profile and on first dates. Sure it might send some people packing, but the ones who are drawn to you are better matches anyway.  

"A focus on idiosyncratic preferences can turn the “too many options” problem of dating apps back into a plus. A larger dating pool means there are probably more people out there who are quirky in the particular ways you like. To be successful in the dating market — during cuffing season or otherwise — you just have to make sure your energy is focused on finding them. " 

^^^^^

Earlier:

 Monday, August 11, 2025  Lucky by Design: The Hidden Economics You Need to Get More of What You Want, by Judd Kessler

The national politics of deceased organ donation

 The U.S. transplant system is relatively open to foreign patients, and the NYT reports with some concern the number of foreign citizens receiving scarce organs from deceased donors, sometimes paying full list price to the hospitals involved.  One question I have that I haven't seen addressed in discussions of this type is how many foreign citizens who happen to die while visiting the US become deceased organ donors?

Here's the NYT:

Hospitals Cater to ‘Transplant Tourists’ as U.S. Patients Wait for Organs
International patients can bring a hospital as much as $2 million for a transplant. In recent years, they have typically gotten organs faster than U.S. patients. By Brian M. Rosenthal and Mark Hansen

  "In the past dozen years, more than 1,400 patients from abroad received a transplant in the United States after traveling specifically for the procedure. That was a small fraction of all U.S. transplants, and most transplant centers did not operate on international patients at all.

"But The Times found that a handful of hospitals are increasingly catering to overseas patients, who make up an ever-larger share of their organ recipients: 11 percent for hearts and lungs at the University of Chicago; 20 percent for lungs at Montefiore Medical Center in the Bronx; 16 percent for lungs at UC San Diego Health; 10 percent for intestines at MedStar Georgetown University Hospital in Washington; and 8 percent for livers at Memorial Hermann-Texas Medical Center in Houston.

"In many countries, this would be illegal. World leaders agreed in 2008 to fight so-called transplant tourism, and most nations do not provide organs to overseas patients. Yet the United States has long allowed it. The policy has drawn criticism in the past, such as when organs went to Saudi royals and a Japanese crime boss. 

...

"Dr. Mark Fox, a former chair of the transplant system’s ethics committee, said the findings were troubling, especially because overseas patients do not contribute to America’s pool of donated organs. “The unfortunate reality is that we don’t have enough organs,” he said. “When people jet in, get an organ and jet home, it’s a problem. It’s not fair.” 

 ##########

I'm reminded of this 2018 article which expressed a similar concern :

Delmonico, F. L., Gunderson, S., Iyer, K. R., Danovitch, G. M., Pruett, T. L., Reyes, J. D., & Ascher, N. L. (2018). Deceased donor organ transplantation performed in the United States for noncitizens and nonresidents. Transplantation, 102(7), 1124-1131. 

Abstract: "Since 2012, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) has required transplant centers to record the citizenship residency status of patients undergoing transplantation in the United States. This policy replaced the 5% threshold of the non–US citizen/nonresidents (NC/NR) undergoing organ transplantation that could result in an audit of transplant center activity. Since April 1, 2015, the country of residence for the NC/NR on the waitlist has also been recorded. We analyzed the frequency of NC/NR deceased donor organ transplants and waitlist registrations at all US transplant centers by data provided by UNOS for that purpose to the UNOS Ad Hoc International Relations Committee. During the period of 2013 to 2016, 1176 deceased donor transplants (of all organs) were performed in non–US citizen/non–US resident (NC/NR) candidates (0.54% of the total number of transplants). We focused on high-volume NC/NR transplant centers that performed more than 5% of the deceased donor kidney or liver transplants in NC/NR or whose waitlist registrants exceeded 5% NC/NR. This report was prepared to fulfill the transparency policy of UNOS to assure a public trust in the distribution of organs. When viewed with a public awareness of deceased donor organ shortages, it suggests the need for a more comprehensive understanding of current NC/NR activity in the United States. Patterns of organ specific NC/NR registrations and transplantations at high-volume centers should prompt a review of transplant center practices to determine whether the deceased donor and center resources may be compromised for their US patients." 

They note that " a noncitizen/nonresident could be a foreign student or businessperson traveling to the United States, whereas an undocumented individual living in the United States would also be a noncitizen/resident." 

The local politics of deceased organ donation

 "All politics is local" may not be entirely true, but local politics doesn't end at death.

MedPage Today has the story: 

Senators Urge More Localized Use of Donor Organs
— "Too many of our organs are leaving" the geographic area, says Sen. Roger Marshall, MD
by Joyce Frieden, 

"More needs to be done to make sure donated organs are transplanted to recipients within the local geographic area whenever possible, several senators said Thursday at a hearing on the future of the organ procurement and transplantation network.

"The Midwest, where I'm from ... is famous that we have a higher organ donor rate than the [East or West] coasts do typically," said Sen. Roger Marshall, MD (R-Kansas). "And you know, there's a concern that too many of our organs are leaving the Midwest." 

Australia's ban on social media use by teens under sixteen

 Australia has put into effect a ban on social media use by teenagers younger than 16.  My first thought is, good luck with that...

Here are some headlines that caught my eye:

From MSN: 

Australian leader defends social media ban as teens flaunt workarounds  by Byron Kaye 

"A day after the law took effect with bipartisan support from the major political parties and backing by some three-quarters of Australian parents, the country's social media feeds were flooded with comments from people claiming to be under 16, including one on the prime minister's TikTok account saying "I'm still here, wait until I can vote".

####### 

And (more optimistically) from Nature:

Australia’s world-first social media ban is a ‘natural experiment’ for scientists
Researchers will study the effects of the policy on young people’s mental health, social interactions and political engagement.   By Rachel Fieldhouse & Mohana Basu 

" Many teenagers in the country are furious, but for social scientists, the policy offers a natural experiment to study the effects of social-media restrictions on young people." 

########

And this:

Social Media Lab Appointed as Lead Academic Partner for Australian Legislation 

Nottingham's Centre for Decision Research and Experimental Economics celebrates its 25th anniversary

 In September, Nottingham's productive center for experimental economics celebrated a quarter century since it's founding: 

 CeDEx 25th Anniversary Workshop .

I just saw the announcement now, but maybe that's a sign of how successfully experimental economics has become established in the profession, over the last century and around the world.

 For some early history, see e.g. 

Roth, Alvin E. "The early history of experimental economics." Journal of the History of Economic Thought 15.2 (1993): 184-209.

 

Crypto has found a use, and it's money laundering

The NYT has the story:

How a Cryptocurrency Helps Criminals Launder Money and Evade Sanctions
Through layers of intermediaries, stablecoins can be moved, swapped and mixed into pools of other funds in ways that are difficult to trace, experts say.  By Aaron Krolik

"Smugglers, money launderers and people facing sanctions once relied on diamonds, gold and artwork to store illicit fortunes. The luxury goods could help hide wealth but were cumbersome to move and hard to spend.

"Now, criminals have a far more practical alternative: stablecoins, a cryptocurrency tied to the U.S. dollar that exists largely beyond traditional financial oversight.

"These digital tokens can be bought with a local currency and moved across borders almost instantly. Or they can be returned to the traditional banking system — including by converting funds into debit cards — often without detection, a New York Times review of corporate filings, online forum messages and blockchain data shows.

"A report released in February from Chainalysis, a blockchain analysis firm, estimated that up to $25 billion in illicit transactions involved stablecoins last year. And as more Russian oligarchs, Islamic State leaders and others have begun using the cryptocurrency, the rise of these dollar-linked tokens threatens to undermine one of America’s most potent foreign policy tools: cutting adversaries off from the dollar and the global banking system.
...

"To test just how easily crypto can slip between the cracks of banking controls, I found a crypto A.T.M. in Weehawken, N.J., to convert cash into stablecoins.

"Soon after I fed two $20 bills into the machine, I received a notification on my phone that crypto had arrived in my digital wallet. A Telegram bot then guided me through the next step: using the stablecoins to generate a Visa payment card number with a balance that I could spend anywhere.

"A payment card functions very much like a debit card, though it is not tied to any of my bank accounts. In this case, the card I was issued did not require me to provide an address or identity check of any kind — in effect creating a degree of anonymity for my spending. 

...

"Tether, which has over $180 billion worth of stablecoins in circulation, is based in El Salvador and would not be covered by the new rules. The company holds more than $112 billion in U.S. Treasuries, and any law enforcement action against Tether could potentially risk destabilizing important financial markets.

"The picture is further complicated by political and financial ties surrounding Tether. The company has close connections to the family of Commerce Secretary Howard Lutnick, who is responsible for restricting exports of sensitive U.S. technology — restrictions that people can try to sidestep by making transactions with stablecoins like Tether. 

"One of Mr. Lutnick’s sons, Brandon, is the chairman of Cantor Fitzgerald, which provides services to Tether, placing the family in a position where the company behind the world’s largest offshore dollar token intersects with a key federal enforcement role. Another son, Kyle, is executive vice chairman of the firm.

"Cantor Fitzgerald and the Commerce Department declined to comment." 

The former governor of Indiana is pleasantly surprised by Harvard

 Eric Holcomb taught a seminar at Harvard after stepping down as governor of Indiana.  He reports that he expected to find a woke hell, but instead found a thriving university.  He attributes that in part to President Trump's war on American universities in general and on Harvard in particular.

I was a red state governor. What I saw at Harvard surprised me.
The spirit of association remains alive in unexpected places.   By Eric Holcomb
Eric Holcomb, a Republican, was the governor of Indiana from 2017 to 2025.

"In January, I completed two terms as governor of Indiana. This fall, I did what all red state Republicans do (right?): spent a semester teaching at Harvard University. As someone who believes that restoring our communities is among America’s greatest challenges, my goal was to see if the foundation of an open-minded, problem-solving community still existed in a place far removed from my own cultural comfort zone. It does.

...

"I found a community that didn’t always agree but could still talk with each other and work together toward the greater good, which in Harvard’s case includes education, discovery and the development of ideas and technologies.

...

"What I’ve experienced may be a natural return to Harvard’s more moderate bearings, following noisy displays of intolerance by campus agitators in recent years. Or it may be due to the Trump administration’s forceful executive orders and fiscal pressure. Either way (and it’s probably both), let’s take the win and learn the broader lesson." 

Kate Ho (1972-2025)

 Kate Ho has passed away, tragically early.  I met her when she was a grad student at Harvard, who worked with Ariel Pakes.

Here's the Econometric Society announcement:

In Memoriam: Kate Ho 

"We are deeply saddened by the passing of Kate Ho, the John L. Weinberg Professor of Economics and Business Policy at Princeton University and a Fellow of the Econometric Society. Kate was a brilliant IO economist and scholar whose impact on the profession will resonate for many years to come.

Among her numerous achievements, Kate delivered the 2021 Fisher-Schultz Lecture of the Econometric Society and received the 2020 Frisch Medal for the best applied paper published in Econometrica over the previous four years, recognizing her pathbreaking work on contracting and insurer competition in health care markets. She served as Co-Editor of Econometrica from 2021 to 2025, contributing with extraordinary dedication and insight. She was also an elected member of the Council of the Econometric Society from 2021 to 2024 and served on many other Society committees. Beyond her professional excellence, Kate was an exceptionally kind, thoughtful, and collaborative colleague. We will miss her deeply.

We extend our heartfelt condolences to Kate’s family, friends, colleagues, and all who were fortunate enough to know her." 

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. 

######

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.

######

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."
 

Abortions in the U.S. since state bans have been enacted

 It's hard to effectively ban something that is legal in neighboring jurisdictions.

The NYT has the story:

A Small Illinois City at the Center of a Seismic Shift in Abortion Access. 
Carbondale, Ill., a liberal enclave within driving distance of 10 states with abortion bans, has become a hub for the procedure. Last year there were nearly 11,000 abortions in this city of 21,000.   By Elizabeth Williamson

"Abortion is legal in Illinois, but the state is surrounded by others that have largely banned the procedure in the three years since the Supreme Court overturned Roe v. Wade. As a result, Illinois now leads the nation in out-of-state abortion patients. Carbondale, a college town in Illinois’s southern tip within driving distance of 10 states with abortion bans, has become a major abortion hub.

"Last year three clinics in this city of 21,000 provided close to 11,000 abortions, almost all for women from other states. The numbers, provided by the clinics, account for nearly a third of all out-of-state abortions in Illinois. 

,,,

"The clinics have already drawn protests as well as intervention efforts from Coalition Life, a St. Louis-based anti-abortion group that stations “sidewalk counselors” outside Carbondale’s clinics.

...

"In states without total bans, there were 1,038,100 clinician-provided abortions in 2024, according to the Guttmacher Institute, a research organization that supports abortion rights. The number includes 155,000 abortions for patients who had crossed state lines. Overall, the number of abortions in the country has slightly increased since the Dobbs decision, largely because of medication abortions."

 

Why I Chose to Get E. Coli. — by Josh Morrison

 Josh Morrison is a glutton for (effective) altruism: he's a nondirected kidney donor (who founded the advocacy organization WaitlistZero), and he's an advocate of human challenge trials for vaccines, who founded the organization OneDaySooner.  He reports his own recent experiences as a challenge trial participant, in MedPage Today:

Why I Chose to Get E. Coli. — Human challenge trials can accelerate medical innovation  by Josh Morrison

" challenge trials have been essential for scientific advancements that may not have been possible (or would have taken much longer) with traditional studies. Challenge studies were crucial to developing malaria vaccines. The correlates of protection they established for influenza immunology are still used to license flu vaccines today, and they played an important role in discovering the origins of both ulcers and yellow fever.

"The E. coli vaccine study I joined was at the University of Maryland School of Medicine's Center for Vaccine Development (CVD). Two of my friends had been in studies at the CVD and had positive experiences overall. I felt like the E.coli vaccine in particular was an important one, so I decided it was time for me to participate too.

"To start, half the participants received the first vaccine in the series and half got a placebo. These initial shots and their associated follow-up were part of eight appointments over 3 months. At our appointments, we had our vitals checked and, in some cases, we had our blood collected or received another vaccine. At appointments the week after a vaccination, we'd provide a stool sample. The study culminated in a 9-day quarantine in Baltimore where were we were exposed to the infectious agent: It was time to drink the E. coli.

"The E. coli was suspended in a bicarbonate solution and tasted like Gatorade without the sugar or flavoring. I remember chuckling nervously as I drank it alongside my fellow participants. It was such an odd experience; I felt like an astronaut counting down for liftoff. 

...

"People's motivations for being in the study included the money (about $4,500). But most of my fellow participants were also excited about the chance to be part of important research and were motivated by the novelty of the experience.

...

"

This was the first challenge study I've participated in, despite having been connected to the field for 5 years. I run 1Day Sooner, a nonprofit that advocates on behalf of challenge study volunteers. Some of my colleagues have been challenged in Shigella, Zika, Malaria, COVID, and Salmonella studies. But I never have because I live in New York and I'm not aware of any institutions in New York that run challenge studies. That may sound surprising, but there are only about 30 challenge studies globally each year, and the U.S. is a relative laggard compared to Europe.

"You might be wondering, would I participate in another one? I would, though I'd prefer something outpatient that didn't require a strict quarantine."

 

 

Disagreement in Science: Missing Women by David Klinowski

 Here's an study of women in science that explores a novel angle.

David Klinowski; Voicing Disagreement in Science: Missing Women. The Review of Economics and Statistics 2025; 107 (6): 1743–1753. doi: https://doi.org/10.1162/rest_a_01322 

Abstract: This paper examines the authorship of post-publication criticisms in the scientific literature, with a focus on gender differences. Bibliometrics from journals in the natural and social sciences show that comments that criticize or correct a published study are 20% to 40% less likely than regular papers to have a female author. In preprints in the life sciences, prior to peer review, women are missing by 20% to 40% in failed replications compared to regular papers, but they are not missing in successful replications. In an experiment, I then find large gender differences in willingness to point out and penalize a mistake in someone's work.