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A methodological framework for optimally reorganizing liver transplant regions.
James E Stahl1, Nan Kong, Steven M Shechter
1Department of Radiology & Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA. James@mgh-ita.org
Summary
Reorganizing organ procurement organization (OPO) regions can increase liver transplants. This study developed a framework to optimize transplant allocation efficiency and geographic parity, potentially saving more lives.
Area of Science:
- Organ transplantation logistics
- Health services research
- Operations research in healthcare
Background:
- The United States currently has 11 organ procurement organization (OPO) regions of varying sizes.
- Current OPO region configurations impact organ travel time and post-transplant viability.
- Optimizing these regions is crucial for efficient organ allocation.
Purpose of the Study:
- To establish a methodologic framework for optimizing OPO region configurations.
- To maximize transplant allocation efficiency and geographic parity across regions.
- To improve organ viability by minimizing travel time.
Main Methods:
- Developed an integer programming model to optimize region configuration.
- The model maximized intraregional transplants and geographic parity.
- Sensitivity analyses explored different liver travel time-viability functions.
Main Results:
- Reconfiguring OPO regions could increase liver transplants by up to 17-18 per year.
- The number of additional transplants depends on the travel-viability function used.
- Optimized regions enhance both transplant numbers and fairness.
Conclusions:
- Reorganization of OPO regions shows potential to significantly benefit liver transplantation.
- The developed analytic framework is adaptable for optimizing other organ transplant systems.
- This research offers a data-driven approach to improve national organ allocation.