Managing a bone marrow transplant centre to maximise patients' health benefits

We study a Bone Marrow Transplant (BMT) Centre whose objective is to maximise the expected health benefits of the admitted patients. The arrival of patients is a renewal process with generally distributed inter-arrival times, and the length of stay in a transplant room is a generally distributed random variable. Arriving patients are immediately admitted into a transplant room if available; otherwise, they would be added to a finite waiting list called patient reserve. When a transplant room becomes available, a member of the patient reserve is selected for admission. Patients who arrive when all transplant rooms are occupied and the patient reserve is full are referred to other BMT Centres. Because the patient reserve members' health will continue to deteriorate while waiting for a transplant room, our research results illustrate the optimal trade-offs among the number of transplant rooms, the number of spots in the patient reserve, and the expected health benefits of the admitted patients. Our experience with a leading BMT Centre supports the notion that an understanding of these optimal trade-offs is crucial for managers of BMT Centres.