The optimal timing of living-donor liver transplantation

Oguzhan Alagoz*, Lisa M. Maillart, Andrew J. Schaefer, Mark S. Roberts

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1420-1430
Number of pages11
JournalManagement Science
Volume50
Issue number10
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

Keywords

  • Control-limit policy
  • Liver transplantation
  • Markov decision processes
  • Medical decision making
  • Organ transplantation
  • Service operations

ASJC Scopus subject areas

  • Strategy and Management
  • Management Science and Operations Research

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