BACKGROUND: The United States is divided currently into 11 transplant regions, which vary in area and number of organ procurement organizations (OPOs). Region size affects organ travel time and organ viability at transplant. PURPOSE: To develop a methodologic framework for determining optimal configurations of regions maximizing transplant allocation efficiency and geographic parity. METHODS: An integer program was designed to maximize a weighted combination of 2 objectives: 1) intraregional transplants, 2) geographic parity-maximizing the lowest intraregional transplant rate across all OPOs. Two classes of functions relating liver travel time to liver viability were also examined as part of the sensitivity analyses. RESULTS: Preliminary results indicate that reorganizing regions, while constraining their number to 11, resulted in up to 17 additional transplants/year depending on the travel-viability function; when not constrained, it resulted in up to 18/year of increase. CONCLUSION: Our analysis indicates that liver transplantation may benefit through region reorganization. The analytic method developed here should be applicable to other organs and sets of organs.
BACKGROUND: The United States is divided currently into 11 transplant regions, which vary in area and number of organ procurement organizations (OPOs). Region size affects organ travel time and organ viability at transplant. PURPOSE: To develop a methodologic framework for determining optimal configurations of regions maximizing transplant allocation efficiency and geographic parity. METHODS: An integer program was designed to maximize a weighted combination of 2 objectives: 1) intraregional transplants, 2) geographic parity-maximizing the lowest intraregional transplant rate across all OPOs. Two classes of functions relating liver travel time to liver viability were also examined as part of the sensitivity analyses. RESULTS: Preliminary results indicate that reorganizing regions, while constraining their number to 11, resulted in up to 17 additional transplants/year depending on the travel-viability function; when not constrained, it resulted in up to 18/year of increase. CONCLUSION: Our analysis indicates that liver transplantation may benefit through region reorganization. The analytic method developed here should be applicable to other organs and sets of organs.
Authors: S E Gentry; A B Massie; S W Cheek; K L Lentine; E H Chow; C E Wickliffe; N Dzebashvili; P R Salvalaggio; M A Schnitzler; D A Axelrod; D L Segev Journal: Am J Transplant Date: 2013-07-09 Impact factor: 8.086
Authors: Naoru Koizumi; Rajesh Ganesan; Monica Gentili; Chun-Hung Chen; Nigel Waters; Debasree DasGupta; Dennis Nicholas; Amit Patel; Divya Srinivasan; Keith Melancon Journal: Proc Int Conf Health Care Syst Eng (2013) Date: 2014
Authors: Theophilus Dhyankumar Chellappa; Ramasubramaniam Muthurathinasapathy; V G Venkatesh; Yangyan Shi; Samsul Islam Journal: Ann Oper Res Date: 2022-09-25 Impact factor: 4.820
Authors: Ashley E Davis; Sanjay Mehrotra; Vikram Kilambi; Joseph Kang; Lisa McElroy; Brittany Lapin; Jane Holl; Michael Abecassis; John J Friedewald; Daniela P Ladner Journal: Clin J Am Soc Nephrol Date: 2014-06-26 Impact factor: 8.237
Authors: James E Stahl; Jennifer E Kreke; Fawaz Ali Abdul Malek; Andrew J Schaefer; Joseph Vacanti Journal: PLoS One Date: 2008-06-25 Impact factor: 3.240