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The Optimal Timing of Living-Donor Liver Transplantation

Author

Listed:
  • Oguzhan Alagoz

    (Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15261)

  • Lisa M. Maillart

    (Weatherhead School of Management, Case Western Reserve University, Cleveland, Ohio 44106)

  • Andrew J. Schaefer

    (Departments of Industrial Engineering and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261)

  • Mark S. Roberts

    (Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213)

Abstract

Living donors are a significant and increasing source of livers for transplantation, mainly because of the insufficient supply of cadaveric organs. We consider the problem of optimally timing a living-donor liver transplant to maximize the patient's total reward, such as quality-adjusted life expectancy. We formulate a Markov decision process (MDP) model in which the state of the process is described by patient health. We derive structural properties of the MDP model, including a set of intuitive conditions that ensure the existence of a control-limit optimal policy. We use clinical data in our computational experiments, which show that the optimal policy is typically of control-limit type.

Suggested Citation

  • Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2004. "The Optimal Timing of Living-Donor Liver Transplantation," Management Science, INFORMS, vol. 50(10), pages 1420-1430, October.
    • Handle: RePEc:inm:ormnsc:v:50:y:2004:i:10:p:1420-1430
    DOI: 10.1287/mnsc.1040.0287
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    References listed on IDEAS

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