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3233. Wanted, Dead or Alive: Leveraging Deceased Donors for Enhanced Patient Outcomes in Kidney Exchange Programs
Invited abstract in session TD-10: Kidney Exchange II, stream OR in Health Services (ORAHS).
Tuesday, 14:30-16:00Room: 11 (building: 116)
Authors (first author is the speaker)
| 1. | Roby Cremers
|
| Econometric Institute, Erasmus University of Rotterdam | |
| 2. | Twan Dollevoet
|
| Econometric Institute, Erasmus University of Rotterdam | |
| 3. | Joel Joris Van de Klundert
|
| School of Business, Universidad Adolfo Ibanez | |
| 4. | Michal Mankowski
|
| King Abdullah University of Science and Technology |
Abstract
Kidney transplant is crucial for end-stage renal disease patients, yet demand for kidneys surpasses supply. Organs can be obtained from both deceased and living donors, with compatibility between patient and donor being a pivotal factor in the matching process. Kidney Exchange Programs (KEPs) aim to address the kidney shortage issue by facilitating exchanges between living incompatible donor-recipient pairs, either through cycles or through chains initiated by a living donor. To boost transplant rates, the use of deceased donor kidneys to trigger transplant chains has been proposed, which involves the last donor in the chain donating back to the deceased donor waiting list. This study investigates when to use deceased donors to initiate chains, aiming to maximize the total number of transplants, while ensuring patient types on the deceased donor waiting list are not disadvantaged. First, we use an offline Integer Linear Programming framework to assess the efficacy of using deceased chain-initiating kidneys (CIKs) within the existing practice. Building on this foundation, we introduce a stochastic model using Sample Average Approximation to address the dynamic and uncertain nature of the problem. Through simulation, using secondary data from the National Kidney Registry between 2012 and 2016, we show that deceased CIKs can potentially enhance patient outcomes in terms of the number of transplants and wait times, but the results are sensitive to the characteristics of the KEP.
Keywords
- Health Care
Status: accepted
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