Sunday, December 21, 2014

US policy that gives priority to prior organ donors who need a transplant


US policy that gives priority to prior organ donors who need a transplant is working


  • Washington, DC (November 20, 2014) -- Prior organ donors who later need a kidney transplant experience brief waiting times and receive excellent quality kidneys, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings indicate that a US policy that gives priority to prior organ donors on the transplant waiting list is working.
    Live organ donors provide a remarkable gift to relieve another person of the burden of organ failure. While most live kidney donors enjoy excellent health after kidney donation, recent research has revealed that kidney donation is linked with an increased risk of developing kidney failure.
    Because of the gift of kidney donation, prior live organ donors receive priority on the kidney transplant waiting list. Peter Reese, MD MSCE (University of Pennsylvania's Perelman School of Medicine), Vishnu Potluri, MD, MPH (Lankenau Medical Center), and their colleagues looked to see whether the current national kidney allocation policy was succeeding in its goal of minimizing waiting time to transplant forpeople who had once donated an organ. The researchers analyzed prior organ donors and matched non-donors who were wait-listed during the years 1996 to 2010.
    "The research reveals that, fortunately, these donors did not wait a long time for their kidney transplants and received high quality kidneys," said Dr. Reese. Prior organ donors had much shorter waiting time to receive a kidney transplant, and they received better quality kidneys compared with similar people on the waiting list who had not donated an organ. "This study shows that the policy is working: prior organ donors get rapid access to high quality organs. After transplant, their survival is excellent compared with similar people whowere not organ donors," said Dr. Reese. He noted, however, that most prior organ donors needed dialysis before they received their transplant. Ideally, these prior donors would have received kidney transplants before they ever needed dialysis.
  • Saturday, December 20, 2014

    How Werner Güth's ultimatum game shaped our understanding of social behavior

    Just out in JEBO, and temporarily un-gated, here is a multi-part paper in honor of Werner Guth and the ultimatum game. (Being one of so many coauthors is probably as close as I'll get to the experience of being a high energy physicist or a planetary scientist...)

    How Werner Güth's ultimatum game shaped our understanding of social behavior 

    Friday, December 19, 2014

    Roads and escalators in Japan: national versus regional equilibria

    I presume that drivers drive on the left on roads throughout Japan, and so I wasn't surprised, in Tokyo, to find that pedestrians tend to keep to the left as well, and that on escalators, riders stay to the left to allow those in a hurry to pass on the right.

    But in Osaka, the escalator equilibrium is reversed: on escalators one stays to the right to allow passing on the left. Roads and sidewalks seem to be as in Tokyo however.

    Thursday, December 18, 2014

    Klein Lecture in Osaka, Dec 19 2014

    I'll be speaking Friday in Osaka...

    Prof. AlvinRoth
    2012
    Winner
    Nobel Prize in Economics
    Title: The Economist as Engineer   
    2014.12.19 (Fri.)
    Open15:30 Start16:00
    Conference Room C01-02, 8th Floor, TOWER-C, Knowledge Capital, Grand Front Osaka   MAP
    *Lecture will be given in English

    Reception
    Time: 18:30
    Venue: URGE (3rd Floor, Knowledge Capital, Grand Front Osaka)

    INTERNATIONAL ECONOMICREVIEW
    Osaka University Institute of Social and Economic Research
    6-1 Mihogaoka, Ibaraki, Osaka 567-0047 JAPAN
    E-mail: klein_lecture@iser.osaka-u.ac.jp
    URL: http://www.iser.osaka-u.ac.jp/~ier/lecture2014.html

    Wednesday, December 17, 2014

    Punishing puns in China

    The Chinese government is reported to have taken steps to make puns repugnant. The Guardian has the story:

    China bans wordplay in attempt at pun control
    Officials say casual alteration of idioms risks nothing less than ‘cultural and linguistic chaos’, despite their common usage

    "From online discussions to adverts, Chinese culture is full of puns. But the country’s print and broadcast watchdog has ruled that there is nothing funny about them.
    It has banned wordplay on the grounds that it breaches the law on standard spoken and written Chinese, makes promoting cultural heritage harder and may mislead the public – especially children.
    The casual alteration of idioms risks nothing less than “cultural and linguistic chaos”, it warns.
    Chinese is perfectly suited to puns because it has so many homophones. Popular sayings and even customs, as well as jokes, rely on wordplay.

    Programmes and adverts should strictly comply with the standard spelling and use of characters, words, phrases and idioms – and avoid changing the characters, phrasing and meanings, the order said.But the order from the State Administration for Press, Publication, Radio, Film and Television says: “Radio and television authorities at all levels must tighten up their regulations and crack down on the irregular and inaccurate use of the Chinese language, especially the misuse of idioms.”
    “Idioms are one of the great features of the Chinese language and contain profound cultural heritage and historical resources and great aesthetic, ideological and moral values,” it added.
    “That’s the most ridiculous part of this: [wordplay] is so much part and parcel of Chinese heritage,” said David Moser, academic director for CET Chinese studies at Beijing Capital Normal University.
    When couples marry, people will give them dates and peanuts – a reference to the wish Zaosheng guizi or “May you soon give birth to a son”. The word for dates is also zao and peanuts are huasheng.
    The notice cites complaints from viewers, but the examples it gives appear utterly innocuous. In a tourism promotion campaign, tweaking the characters used in the phrase jin shan jin mei – perfection – has turned it into a slogan translated as “Shanxi, a land of splendours”. In another case, replacing a single character in ke bu rong huan has turned “brook no delay” into “coughing must not linger” for a medicine advert."

    Tuesday, December 16, 2014

    Organs and Inducements: Special Issue of Law and Contemporary Problems edited by Cook and Krawiec



    Volume 772014Number 3

    Organs and Inducements

    Philip J. Cook & Kimberly D. Krawiec
    Special Editors

    Foreword
    i
    A Primer on Kidney Transplantation: Anatomy of the Shortage
    1
    Six Decades of Organ Donation and the Challenges That Shifting the United States to a Market System Would Create Around the World
    25
    Regulating the Organ Market: Normative Foundations for Market Regulation
    71
    Perceptions of Efficacy, Morality, and Politics of Potential Cadaveric Organ-Transplantation Reforms
    101
    Philanthropically Funded Heroism Awards for Kidney Donors?
    131
    Reverse Transplant Tourism
    145
    Organs Without Borders? Allocating Transplant Organs, Foreigners, and the Importance of the Nation-State (?)
    175
    State Organ-Donation Incentives Under the National Organ Transplant Act
    217
    Designing a Compensated–Kidney Donation System
    253
    Altruism Exchanges and the Kidney Shortage
    289
    Reciprocal Altruism—the Impact of Resurrecting an Old Moral Imperative on the National Organ Donation Rate in Israel
    323
    Organ Quality as a Complicating Factor in Proposed Systems of Inducements for Organ Donation
    337

    Monday, December 15, 2014

    Virginia Postrel on the new allocation rules for deceased donor kidneys

    Virginia Postrel is skeptical about the new rules for allocating deceased donor kidneys, and thinks there is likely to be some good news (about slower-growing waiting lists) that will just be an artifact of removing some incentives to get on the list early.

    Old, Sick and Need a Kidney? Good Luck

    "Within a few years, new rules about allocating kidneys, which went into effect last week, could shrink the waiting list. But this apparent improvement will be an illusion -- an artifact of the incentives the new rules create, not genuine progress. Changing who gets priority for scarce kidneys will help some patients and hurt others, and it might squeeze out a few more total years of healthy living for the lucky recipients. But a different process for managing the existing supply of kidneys won’t make a serious difference for the skyrocketing number of patients who need transplants.
    In the past, how long you’d been on the waiting list was the main factor that determined how close you were to getting a compatible kidney. (Some blood types are harder to match than others, so someone with less compatible type O blood would wait longer than someone with type A.) The longer you waited, the further you moved up the list. The clock started when your transplant center did the necessary tests and listed you as a transplant candidate.
    The old system hurt those patients, most of whom were black, who had spent years on dialysis before they got referred for transplants, whether because of medical factors, insufficient health insurance or complacent nephrologists. (About a third of the patients, about 35,000 people, currently on the waiting list are black.) The new system instead starts the clock when a patient goes on dialysis.
    “In the previous system, it would make sense to list somebody even if they weren’t quite ready to get a transplant, so they could accrue waiting time,” Benjamin E. Hippen, a transplant nephrologist at Carolinas Medical Center in Charlotte, North Carolina, explained in an interview. Now, since they won’t have a shot at a kidney for years, there’s no reason to put them on the waiting list so soon. “It’s going to look like the overall list has shrunk,” he predicted, “when really it’s just a strategic move by the transplant center.”
    While arguably fairer, counting dialysis years creates much more uncertainty. Every time a new patient is added, that person’s dialysis history rejiggers the list. It’s like waiting for an airline upgrade: If you’re a lowly gold status member, you may start out at the head of the line, only to end up in coach as platinum and executive platinum travelers put in their requests and push you down the queue. In this case, there’s a lot more at stake than more legroom and better meals."
    ...
    “The people who lose in all this are going to be the people who are a little older, who are diabetic and who don’t have a lot of years of waiting time -- which is most patients,” said Hippen, a critic of the new system. “That sort of describes the average new patient.”