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A Methodological Framework for Optimally Reorganizing Liver Transplant Regions

Author

Listed:
  • James E. Stahl

    (Department of Radiology & Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston)

  • Nan Kong

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

  • Steven M. Shechter

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

  • Andrew J. Schaefer

    (Department of Industrial Engineering, University of Pittsburgh, Pennsylvania, Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania)

  • Mark S. Roberts

    (Department of Industrial Engineering, University of Pittsburgh, Pennsylvania, Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania)

Abstract

Background. The United States is divided currently into 11 transplant regions, which vary in area and number of organ procurement organizations (OPOs). Region size affects organ travel time and organ viability at transplant. Purpose. To develop a methodologic framework for determining optimal configurations of regions maximizing transplant allocation efficiency and geographic parity. Methods. An integer program was designed to maximize a weighted combination of 2 objectives: 1) intraregional transplants, 2) geographic parity—maximizing the lowest intraregional transplant rate across all OPOs. Two classes of functions relating liver travel time to liver viability were also examined as part of the sensitivity analyses. Results. Preliminary results indicate that reorganizing regions, while constraining their number to 11, resulted in up to 17 additional transplants/year depending on the travel-viability function; when not constrained, it resulted in up to 18/year of increase. Conclusion. Our analysis indicates that liver transplantation may benefit through region reorganization. The analytic method developed here should be applicable to other organs and sets of organs.

Suggested Citation

  • James E. Stahl & Nan Kong & Steven M. Shechter & Andrew J. Schaefer & Mark S. Roberts, 2005. "A Methodological Framework for Optimally Reorganizing Liver Transplant Regions," Medical Decision Making, , vol. 25(1), pages 35-46, January.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:1:p:35-46
    DOI: 10.1177/0272989X04273137
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    References listed on IDEAS

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    1. Ozge Ceren Ersoy & Diwakar Gupta & Timothy Pruett, 2021. "A critical look at the U.S. deceased‐donor organ procurement and utilization system," Naval Research Logistics (NRL), John Wiley & Sons, vol. 68(1), pages 3-29, February.
    2. Nan Kong & Andrew J. Schaefer & Brady Hunsaker & Mark S. Roberts, 2010. "Maximizing the Efficiency of the U.S. Liver Allocation System Through Region Design," Management Science, INFORMS, vol. 56(12), pages 2111-2122, December.
    3. Syam, Siddhartha S. & Côté, Murray J., 2010. "A location-allocation model for service providers with application to not-for-profit health care organizations," Omega, Elsevier, vol. 38(3-4), pages 157-166, June.
    4. Theophilus Dhyankumar Chellappa & Ramasubramaniam Muthurathinasapathy & V. G. Venkatesh & Yangyan Shi & Samsul Islam, 2023. "Location of organ procurement and distribution organisation decisions and their impact on kidney allocations: a developing country perspective," Annals of Operations Research, Springer, vol. 321(1), pages 755-781, February.
    5. Kargar, Bahareh & Pishvaee, Mir Saman & Jahani, Hamed & Sheu, Jiuh-Biing, 2020. "Organ transportation and allocation problem under medical uncertainty: A real case study of liver transplantation," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 134(C).
    6. Sinem Savaşer & Ömer Burak Kınay & Bahar Yetis Kara & Pelin Cay, 2019. "Organ transplantation logistics: a case for Turkey," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 41(2), pages 327-356, June.
    7. Sakine Batun & Andrew J. Schaefer & Atul Bhandari & Mark S. Roberts, 2018. "Optimal Liver Acceptance for Risk-Sensitive Patients," Service Science, INFORMS, vol. 10(3), pages 320-333, September.
    8. Sommer Gentry & Eric Chow & Allan Massie & Dorry Segev, 2015. "Gerrymandering for Justice: Redistricting U.S. Liver Allocation," Interfaces, INFORMS, vol. 45(5), pages 462-480, October.
    9. Barış Ata & Anton Skaro & Sridhar Tayur, 2017. "OrganJet: Overcoming Geographical Disparities in Access to Deceased Donor Kidneys in the United States," Management Science, INFORMS, vol. 63(9), pages 2776-2794, September.
    10. Mehmet C. Demirci & Andrew J. Schaefer & H. Edwin Romeijn & Mark S. Roberts, 2012. "An Exact Method for Balancing Efficiency and Equity in the Liver Allocation Hierarchy," INFORMS Journal on Computing, INFORMS, vol. 24(2), pages 260-275, May.
    11. Sahar Ahmadvand & Mir Saman Pishvaee, 2018. "An efficient method for kidney allocation problem: a credibility-based fuzzy common weights data envelopment analysis approach," Health Care Management Science, Springer, vol. 21(4), pages 587-603, December.
    12. Navneet Vidyarthi & Onur Kuzgunkaya, 2015. "The impact of directed choice on the design of preventive healthcare facility network under congestion," Health Care Management Science, Springer, vol. 18(4), pages 459-474, December.

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