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.

• 저널Management Science · 50(10) · 1420–1430
• 토픽Organ Transplantation Techniques and Outcomes · Surgery
• DOI10.1287/mnsc.1040.0287
• 저자Oğuzhan Alagöz, Lisa M. Maillart, Andrew J. Schaefer, Mark S. Roberts