The Optimal Timing of Living-Donor Liver Transplantation

Oguzhan Alagoz (), Lisa M. Maillart (), Andrew J. Schaefer () and Mark S. Roberts ()
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Oguzhan Alagoz: Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
Lisa M. Maillart: Weatherhead School of Management, Case Western Reserve University, Cleveland, Ohio 44106
Andrew J. Schaefer: Departments of Industrial Engineering and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
Mark S. Roberts: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213

Management Science, 2004, vol. 50, issue 10, 1420-1430

Abstract: 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.

Keywords: medical decision making; Markov decision processes; control-limit policy; organ transplantation; liver transplantation; service operations (search for similar items in EconPapers)
Date: 2004
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Citations: View citations in EconPapers (56)

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