Valuing Sets of Potential Transplants in a Kidney Paired Donation Network.
Valuing Sets of Potential Transplants in a Kidney Paired Donation Network.
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DOI：
10.1007/s12561-018-9214-7
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发表时间：
2018-04
影响因子：
1
通讯作者：
Kalbfleisch JD
中科院分区：
文献类型：
--
作者：
Bray M;Wang W;Song PX;Kalbfleisch JD
在肾配对捐赠（KPD）中，不相容的供体-候选对和非定向（也称为利他）供体汇集在一起，目的是通过供体交换实现移植的总效用最大化。我们考虑这样一种设置，即定期选择不连接的潜在移植集，在个体供体、候选器官或匹配失败的情况下，在每个建议集内提供备选方案。我们开发了在KPD的现实概率模型下计算这些集合的期望效用的方法。将这些集的精确期望效用计算与基于底层网络的蒙特卡罗样本的估计进行比较。模型和方法被扩展到包括有多个不相容供体加入KPD的移植候选人。微模拟表明，在实现移植和候选者等待时间方面，考虑失败概率和备选方案以及候选者与其他供者的联合方面具有优势。
In kidney paired donation (KPD), incompatible donor-candidate pairs and non-directed (also known as altruistic) donors are pooled together with the aim of maximizing the total utility of transplants realized via donor exchanges. We consider a setting in which disjoint sets of potential transplants are selected at regular intervals, with fallback options available within each proposed set in the case of individual donor, candidate or match failure. We develop methods for calculating the expected utility for such sets under a realistic probability model for the KPD. Exact expected utility calculations for these sets are compared to estimates based on Monte Carlo samples of the underlying network. Models and methods are extended to include transplant candidates who join KPD with more than one incompatible donor. Microsimulations demonstrate the superiority of accounting for failure probability and fallback options, as well as candidates joining with additional donors, in terms of realized transplants and waiting time for candidates.