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Related Experiment Video

Updated: Oct 23, 2025

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy
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Gerrymandering for Justice: Redistricting U.S. Liver Allocation.

Sommer Gentry1, Eric Chow2, Allan Massie3

  • 1Mathematics Department, United States Naval Academy, Annapolis, Maryland 21402; and Johns Hopkins University School of Medicine, Baltimore, Maryland 21287.

Interfaces
|August 23, 2021
PubMed
Summary

Redistricting U.S. organ allocation policy can reduce geographic disparities in liver availability. This change aims to save hundreds of lives by improving liver transplant offers for patients based on medical urgency.

Keywords:
healthcareliverlocation allocationredistrictingset partitioningtransplantationzero-one integer programming

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Area of Science:

  • Transplantation research
  • Health policy analysis
  • Operations research

Background:

  • Current U.S. organ allocation policy geographically isolates deceased donor livers.
  • This policy hinders timely transplantation based on medical urgency.
  • Geographic inequities exist in liver transplant offer distribution.

Purpose of the Study:

  • To optimize U.S. liver allocation policy by minimizing geographic disparities in organ availability.
  • To propose a redistricting plan for donor service areas to improve liver distribution.
  • To enhance the efficiency and equity of the liver transplant system.

Main Methods:

  • Utilized a zero-one integer programming model to partition 58 donor service areas into 4-8 sharing districts.
  • Minimized disparities in liver availability across the proposed districts.
  • Employed discrete-event simulation to evaluate optimized district maps at a granular level.

Main Results:

  • Developed optimized district maps (4 and 8 districts) to reduce geographic inequity in liver allocation.
  • The proposed redistricting plan was recognized by the Organ Procurement and Transplantation Network (OPTN) liver committee.
  • A policy proposal based on these maps was initiated for potential implementation.

Conclusions:

  • Redistricting liver allocation can significantly improve geographic equity in transplant offers.
  • Implementing optimized allocation districts is projected to save hundreds of lives within five years.
  • Policy changes are recommended to address current inequities and enhance patient outcomes.