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Deciding Eligibility for Transplantation When a Donor Kidney Becomes Available

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  • John Hornberger
  • Jae-Hyeon Ahn

Abstract

The expectation of transplant success for some patient/donor-kidney matches can be so low that transplantation is not considered an option. The issue may be framed as deciding the minimum expectation of transplant success that would justify a patient's eligibility for transplantation with an available donor kidney. If the minimum is set too high, the patient will be eligible for very few donor kidneys and will wait excessively for transplantation. If the minimum is set too low, the patient has a greater risk of graft failure once transplantation has been done. A decision model calculates the minimum predicted one-year graft survival rate that would determine eligibility for an available donor kidney, with the goal of maximizing quality-adjusted life expectancy. The minimum predicted one-year graft survival rate depends on the patient's health and demographic characteristics and attitudes about quality of life with kidney-replacement therapies. Graft survival rates and quality-adjusted life expectancies may increase by as much 6.7% and 1.6 months, respectively, with only a slight increase (

Suggested Citation

  • John Hornberger & Jae-Hyeon Ahn, 1997. "Deciding Eligibility for Transplantation When a Donor Kidney Becomes Available," Medical Decision Making, , vol. 17(2), pages 160-170, April.
    • Handle: RePEc:sae:medema:v:17:y:1997:i:2:p:160-170
    DOI: 10.1177/0272989X9701700206
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    Cited by:

    1. Stefanos A. Zenios & Glenn M. Chertow & Lawrence M. Wein, 2000. "Dynamic Allocation of Kidneys to Candidates on the Transplant Waiting List," Operations Research, INFORMS, vol. 48(4), pages 549-569, August.
    2. Maria Bruni & Domenico Conforti & Nicola Sicilia & Sandro Trotta, 2006. "A new organ transplantation location–allocation policy: a case study of Italy," Health Care Management Science, Springer, vol. 9(2), pages 125-142, May.
    3. 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.
    4. Bendersky, Michael & David, Israel, 2016. "Deciding kidney-offer admissibility dependent on patients’ lifetime failure rate," European Journal of Operational Research, Elsevier, vol. 251(2), pages 686-693.
    5. Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2007. "Determining the Acceptance of Cadaveric Livers Using an Implicit Model of the Waiting List," Operations Research, INFORMS, vol. 55(1), pages 24-36, February.
    6. Burhaneddin Sandıkçı & Lisa M. Maillart & Andrew J. Schaefer & Oguzhan Alagoz & Mark S. Roberts, 2008. "Estimating the Patient's Price of Privacy in Liver Transplantation," Operations Research, INFORMS, vol. 56(6), pages 1393-1410, December.
    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. 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.
    9. Mustafa Akan & Oguzhan Alagoz & Baris Ata & Fatih Safa Erenay & Adnan Said, 2012. "A Broader View of Designing the Liver Allocation System," Operations Research, INFORMS, vol. 60(4), pages 757-770, August.
    10. Murat Kurt & Mark S. Roberts & Andrew J. Schaefer & M. Utku Ünver, 2011. "Valuing Prearranged Paired Kidney Exchanges: A Stochastic Game Approach," Boston College Working Papers in Economics 785, Boston College Department of Economics, revised 14 Oct 2011.
    11. Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2007. "Choosing Among Living-Donor and Cadaveric Livers," Management Science, INFORMS, vol. 53(11), pages 1702-1715, November.

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