The Optimal Timing of Living-Donor Liver Transplantation
Oguzhan Alagoz, Lisa M. Maillart, Andrew J. Schaefer, Mark S. Roberts
Management Science · 2004 · Volume 50 · Issue 10
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
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