The Optimal Timing of Living-Donor Liver Transplantation
AbstractLiving 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.
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Bibliographic InfoArticle provided by INFORMS in its journal Management Science.
Volume (Year): 50 (2004)
Issue (Month): 10 (October)
medical decision making; Markov decision processes; control-limit policy; organ transplantation; liver transplantation; service operations;
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- Harry J. Paarsch & Alberto M. Segre & John P. Roberts & Jeffrey B. Halldorson, 2011.
"Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System,"
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213, Collegio Carlo Alberto.
- Paarsch, Harry J. & Segre, Alberto M. & Roberts, John P. & Halldorson, Jeffrey B., 2011. "Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System," CIS Discussion paper series 522, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
- Caulkins, Jonathan P., 2010. "Might randomization in queue discipline be useful when waiting cost is a concave function of waiting time?," Socio-Economic Planning Sciences, Elsevier, vol. 44(1), pages 19-24, March.
- Baruch Keren & Joseph Pliskin, 2011. "Optimal timing of joint replacement using mathematical programming and stochastic programming models," Health Care Management Science, Springer, vol. 14(4), pages 361-369, November.
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