{"title":"Long term simulation analysis of deceased donor initiated chains in kidney exchange programs.","authors":"Utkarsh Verma, Nayaran Rangaraj, Viswanath Billa, Deepa Usulumarty","doi":"10.1080/20476965.2023.2197023","DOIUrl":null,"url":null,"abstract":"<p><p>Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a ©DD donates kidneys directly to a©DD wait-list. The idea of initiating an exchange chain starting from a ©DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates ©DD-initiated chains, considering both paired exchange registry and ©DD allocations simultaneously and addressing the overlap issue between the exchange registry and ©DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to ©analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of ©DDs, these chains can significantly increase potential transplants.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123553/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Systems","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/20476965.2023.2197023","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a ©DD donates kidneys directly to a©DD wait-list. The idea of initiating an exchange chain starting from a ©DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates ©DD-initiated chains, considering both paired exchange registry and ©DD allocations simultaneously and addressing the overlap issue between the exchange registry and ©DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to ©analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of ©DDs, these chains can significantly increase potential transplants.
肾脏交换计划中已故供者启动链的长期模拟分析
肾脏交换项目已经发展起来，为有不相容供体的受者寻找相容的肾脏。另一方面，没有活体捐赠者的患者依靠已故捐赠者(DD)的捐赠来获得肾脏移植。目前，在印度，已故捐赠者直接将肾脏捐赠给等待捐赠的已故捐赠者。在一些文章中提出了从已故捐赠者的肾脏开始启动交换链的想法(最近在意大利实施)，但没有给出这种合并的数学公式。我们引入了一个整数规划公式，该公式可以创建已故捐赠者发起的链，同时考虑配对交换注册和已故捐赠者分配。配对交换登记和已故捐赠者等候名单登记数据之间可能存在重叠，因为接受者可以独立地为这两个登记进行登记。本文也对此进行了论述。我们进行了长期的模拟研究，以分析这些DD启动链随时间的增益。这表明，即使只有少量的已故捐献者，这些器官链也能显著增加潜在的移植数量。此外，合并注册表中的等待时间和退出率也大大降低。
本文章由计算机程序翻译，如有差异，请以英文原文为准。
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