IDEAS home Printed from https://ideas.repec.org/a/inm/ormnsc/v53y2007i11p1702-1715.html
   My bibliography  Save this article

Choosing Among Living-Donor and Cadaveric Livers

Author

Listed:
  • Oguzhan Alagoz

    (Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706)

  • Lisa M. Maillart

    (Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15261)

  • Andrew J. Schaefer

    (Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15261)

  • Mark S. Roberts

    (Section of Decision Sciences and Clinical Systems Modeling, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213)

Abstract

The only therapy for a patient with end-stage liver disease (ESLD) is liver transplantation, which is performed by using either a cadaveric liver from a deceased donor or a portion of a living-donor's liver. This study addresses the following decision problem for an ESLD patient with an available living donor. Should she have a transplantation now or wait? If she decides to have the transplantation now, should she use her living-donor liver or a cadaveric liver for transplantation? We formulate this problem as a discrete-time, infinite-horizon Markov decision process model and solve it using clinical data. Because living donors are typically related to the recipient, we incorporate a disutility associated with using the living-donor liver as opposed to using a cadaveric liver. We perform a structural analysis of the model, including a set of intuitive conditions that ensure the existence of structured policies such as an at-most-three-region (AM3R) optimal policy. Our computational experiments confirm that the optimal policy is typically of AM3R type.

Suggested Citation

  • 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.
    • Handle: RePEc:inm:ormnsc:v:53:y:2007:i:11:p:1702-1715
    DOI: 10.1287/mnsc.1070.0726
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1287/mnsc.1070.0726
    Download Restriction: no
    File URL: https://libkey.io/10.1287/mnsc.1070.0726?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Israel David & Uri Yechiali, 1995. "One-Attribute Sequential Assignment Match Processes in Discrete Time," Operations Research, INFORMS, vol. 43(5), pages 879-884, October.
    2. Steven M. Shechter & Cindy L. Bryce & Oguzhan Alagoz & Jennifer E. Kreke & James E. Stahl & Andrew J. Schaefer & Derek C. Angus & Mark S. Roberts, 2005. "A Clinically Based Discrete-Event Simulation of End-Stage Liver Disease and the Organ Allocation Process," Medical Decision Making, , vol. 25(2), pages 199-209, March.
    3. 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.
    4. 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.
    5. Rhonda Righter, 1989. "A Resource Allocation Problem in a Random Environment," Operations Research, INFORMS, vol. 37(2), pages 329-338, April.
    6. Cyrus Derman, 1962. "On Sequential Decisions and Markov Chains," Management Science, INFORMS, vol. 9(1), pages 16-24, October.
    7. 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.
    8. Xuanming Su & Stefanos A. Zenios, 2005. "Patient Choice in Kidney Allocation: A Sequential Stochastic Assignment Model," Operations Research, INFORMS, vol. 53(3), pages 443-455, June.
    9. 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.
    10. 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.
    11. 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.
    12. Stefanos A. Zenios, 2002. "Optimal Control of a Paired-Kidney Exchange Program," Management Science, INFORMS, vol. 48(3), pages 328-342, March.
    13. Israel David & Uri Yechiali, 1985. "A Time-dependent Stopping Problem with Application to Live Organ Transplants," Operations Research, INFORMS, vol. 33(3), pages 491-504, June.
    14. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Burhaneddin Sandıkçı & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2013. "Alleviating the Patient's Price of Privacy Through a Partially Observable Waiting List," Management Science, INFORMS, vol. 59(8), pages 1836-1854, August.
    2. Nikhil N. Dhakate & Rohit Joshi, 2020. "Analysing Process of Organ Donation and Transplantation Services in India at Hospital Level: SAP-LAP Model," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 21(4), pages 323-339, December.
    3. Mason, J.E. & Denton, B.T. & Shah, N.D. & Smith, S.A., 2014. "Optimizing the simultaneous management of blood pressure and cholesterol for type 2 diabetes patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 727-738.
    4. Oguzhan Alagoz & Heather Hsu & Andrew J. Schaefer & Mark S. Roberts, 2010. "Markov Decision Processes: A Tool for Sequential Decision Making under Uncertainty," Medical Decision Making, , vol. 30(4), pages 474-483, July.
    5. 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.
    6. 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.
    7. Zeynep Erkin & Matthew D. Bailey & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2010. "Eliciting Patients' Revealed Preferences: An Inverse Markov Decision Process Approach," Decision Analysis, INFORMS, vol. 7(4), pages 358-365, December.
    8. Jinghua Shi & Oguzhan Alagoz & Fatih Erenay & Qiang Su, 2014. "A survey of optimization models on cancer chemotherapy treatment planning," Annals of Operations Research, Springer, vol. 221(1), pages 331-356, October.
    9. Sen Lin & Bo Li & Antonio Arreola-Risa & Yiwei Huang, 2023. "Optimizing a single-product production-inventory system under constant absolute risk aversion," TOP: An Official Journal of the Spanish Society of Statistics and Operations Research, Springer;Sociedad de Estadística e Investigación Operativa, vol. 31(3), pages 510-537, October.
    10. 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.
    11. Miao He & Lei Zhao & Warren Powell, 2010. "Optimal control of dosage decisions in controlled ovarian hyperstimulation," Annals of Operations Research, Springer, vol. 178(1), pages 223-245, July.
    12. Klein, Michael G. & Verter, Vedat & Moses, Brian G., 2020. "Designing a rural network of dialysis facilities," European Journal of Operational Research, Elsevier, vol. 282(3), pages 1088-1100.
    13. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. Dimitris Bertsimas & Vivek F. Farias & Nikolaos Trichakis, 2013. "Fairness, Efficiency, and Flexibility in Organ Allocation for Kidney Transplantation," Operations Research, INFORMS, vol. 61(1), pages 73-87, February.
    6. 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.
    7. 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).
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. Zahra Gharibi & Michael Hahsler, 2021. "A Simulation-Based Optimization Model to Study the Impact of Multiple-Region Listing and Information Sharing on Kidney Transplant Outcomes," IJERPH, MDPI, vol. 18(3), pages 1-20, January.
    13. Yael Deutsch & Israel David, 2020. "Benchmark policies for utility-carrying queues with impatience," Queueing Systems: Theory and Applications, Springer, vol. 95(1), pages 97-120, June.
    14. 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.
    15. Sang-Phil Kim & Diwakar Gupta & Ajay Israni & Bertram Kasiske, 2015. "Accept/decline decision module for the liver simulated allocation model," Health Care Management Science, Springer, vol. 18(1), pages 35-57, March.
    16. Burhaneddin Sandıkçı & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2013. "Alleviating the Patient's Price of Privacy Through a Partially Observable Waiting List," Management Science, INFORMS, vol. 59(8), pages 1836-1854, August.
    17. Xuanming Su & Stefanos A. Zenios, 2005. "Patient Choice in Kidney Allocation: A Sequential Stochastic Assignment Model," Operations Research, INFORMS, vol. 53(3), pages 443-455, June.
    18. Xuanming Su & Stefanos A. Zenios, 2006. "Recipient Choice Can Address the Efficiency-Equity Trade-off in Kidney Transplantation: A Mechanism Design Model," Management Science, INFORMS, vol. 52(11), pages 1647-1660, November.
    19. Baris Ata & Yichuan Ding & Stefanos Zenios, 2021. "An Achievable-Region-Based Approach for Kidney Allocation Policy Design with Endogenous Patient Choice," Manufacturing & Service Operations Management, INFORMS, vol. 23(1), pages 36-54, 1-2.
    20. 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.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:ormnsc:v:53:y:2007:i:11:p:1702-1715. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.