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: | Schaefer Andrew J., Maillart Lisa M., Alagoz Oguzhan, Roberts Mark S. |
Keywords: | markov processes, decision |
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.