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Pausing transplants in the face of a global pandemic: Patient survival implications

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Listed:
  • Minmin Zhang
  • Guihua Wang
  • Jun Li
  • Wallace J. Hopp
  • David D. Lee

Abstract

The coronavirus disease 2019 (COVID‐19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID‐19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant centers considered the possibility of slowing down and even potentially pausing all transplants. Many proposals regarding the need for pausing organ transplants exist; however, much remains unknown. Whereas the impact of the COVID‐19 pandemic on the overall healthcare system is unknown, the potential impact of pausing organ transplants over a period can be estimated. This study presents a model for evaluating the impact of pausing liver transplants over a spectrum of model for end‐stage liver disease‐sodium (MELD‐Na) scores. Our model accounts for two potential risks of a pause: (1) the waitlist mortality of all patients who do not receive liver transplants during the pause period, and (2) the impact of a longer waiting list due to the pause of liver transplants and the continuous accrual of new patients. Using over 12 years of liver transplant data from the United Network for Organ Sharing and a system of differential equations, we estimate the threshold probability above which a decision maker should pause liver transplants to reduce the loss of patient life months. We also compare different pause policies to illustrate the value of patient‐specific and center‐specific approaches. Finally, we analyze how capacity constraints affect the loss of patient life months and the length of the waiting list. The results of this study are useful to decision makers in deciding whether and how to pause organ transplants during a pandemic. The results are also useful to patients (and their care providers) who are waiting for organ transplants.

Suggested Citation

  • Minmin Zhang & Guihua Wang & Jun Li & Wallace J. Hopp & David D. Lee, 2023. "Pausing transplants in the face of a global pandemic: Patient survival implications," Production and Operations Management, Production and Operations Management Society, vol. 32(5), pages 1380-1396, May.
  • Handle: RePEc:bla:popmgt:v:32:y:2023:i:5:p:1380-1396
    DOI: 10.1111/poms.13697
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    References listed on IDEAS

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    1. Priyank Arora & Ravi Subramanian, 2019. "Improving Societal Outcomes in the Organ Donation Value Chain," Production and Operations Management, Production and Operations Management Society, vol. 28(8), pages 2110-2131, August.
    2. Mazhar Arıkan & Barış Ata & John J. Friedewald & Rodney P. Parker, 2018. "Enhancing Kidney Supply Through Geographic Sharing in the United States," Production and Operations Management, Production and Operations Management Society, vol. 27(12), pages 2103-2121, December.
    3. Wallace J. Hopp & Jun Li & Guihua Wang, 2018. "Big Data and the Precision Medicine Revolution," Production and Operations Management, Production and Operations Management Society, vol. 27(9), pages 1647-1664, September.
    4. Edward H. Kaplan & Avner Hershlag & Alan H. DeCherney & Gady Lavy, 1992. "To Be or Not to Be? That is Conception! Managing In Vitro Fertilization Programs," Management Science, INFORMS, vol. 38(9), pages 1217-1229, September.
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    1. Edward Anderson & Sushil Gupta & Nitin Joglekar & Martin Starr, 2023. "Managing pandemics: A POM perspective and directions for future research," Production and Operations Management, Production and Operations Management Society, vol. 32(5), pages 1295-1306, May.

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