The Optimal Timing of Living-Donor Liver Transplantation
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.
Volume (Year): 50 (2004)
Issue (Month): 10 (October)
|Contact details of provider:|| Postal: 7240 Parkway Drive, Suite 300, Hanover, MD 21076 USA|
Web page: http://www.informs.org/
More information through EDIRC
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Howard J. Weiss, 1979. "The Computation of Optimal Control Limits for a Queue with Batch Services," Management Science, INFORMS, vol. 25(4), pages 320-328, April.
- Chew, Soo Hong & Ho, Joanna L, 1994. "Hope: An Empirical Study of Attitude toward the Timing of Uncertainty Resolution," Journal of Risk and Uncertainty, Springer, vol. 8(3), pages 267-288, May.
- Jae-Hyeon Ahn & John C. Hornberger, 1996. "Involving Patients in the Cadaveric Kidney Transplant Allocation Process: A Decision-Theoretic Perspective," Management Science, INFORMS, vol. 42(5), pages 629-641, May.
- Cyrus Derman, 1963. "Optimal Replacement and Maintenance Under Markovian Deterioration with Probability Bounds on Failure," Management Science, INFORMS, vol. 9(3), pages 478-481, April.
- Chen, Mingchih & Feldman, Richard M., 1997. "Optimal replacement policies with minimal repair and age-dependent costs," European Journal of Operational Research, Elsevier, vol. 98(1), pages 75-84, April.
- Howard, David H., 2002. "Why do transplant surgeons turn down organs?: A model of the accept/reject decision," Journal of Health Economics, Elsevier, vol. 21(6), pages 957-969, November.