The optimal timing of living-donor liver transplantation
The optimal timing of living-donor liver transplantation
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DOI：
10.1287/mnsc.1040.0287
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发表时间：
2004-10-01
影响因子：
5.4
通讯作者：
Roberts, MS
中科院分区：
文献类型：
--
作者：
Alagoz, O;Maillart, LM;Roberts, MS
活体捐赠者是移植肝脏的重要来源，而且还在不断增加，这主要是因为身体器官供应不足。我们考虑的问题是最佳的活体供肝移植时机，以最大化患者的总回报，例如调整质量的预期寿命。我们建立了一个马尔可夫决策过程(MDP)模型，其中过程的状态由患者的健康状况来描述。我们推导了MDP模型的结构性质，包括一组确保存在控制极限最优策略的直观条件。我们用临床数据进行了计算实验，结果表明最优策略通常是控制极限类型的。
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.