The optimal timing of living donor liver transplantation

The optimal timing of living donor liver transplantation

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Article ID: iaor20073812
Country: United States
Volume: 50
Issue: 10
Start Page Number: 1420
End Page Number: 1430
Publication Date: Oct 2004
Journal: Management Science
Authors: , , ,
Keywords: markov processes, decision
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.

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