A Look-Ahead Strategy for Non-Directed Donors in Kidney Paired Donation.
A Look-Ahead Strategy for Non-Directed Donors in Kidney Paired Donation.
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DOI：
10.1007/s12561-016-9155-y
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发表时间：
2017-12
影响因子：
1
通讯作者：
Kalbfleisch JD
中科院分区：
文献类型：
--
作者：
Wang W;Bray M;Song PX;Kalbfleisch JD
尽管治疗终末期肾病的肾移植需求不断增长，但可移植肾的供应却严重短缺。肾脏配对捐赠（KPD）计划为有意愿但不相容捐赠者的候选人提供平台，以评估交换捐赠者的可能性，从而为这些候选人开辟新的移植机会。近年来，非定向（或利他）捐赠者 (NDD) 已被纳入 KPD 计划，开始了使许多候选人受益的移植链。在此类计划中，在移植交换选择中做出最佳决策至关重要。为了从 NDD 开始改进链的选择，本文引入了一种前瞻多重决策策略来选择未来易于扩展的链。采用模拟研究来评估该策略的性能。考虑到链的可扩展性会增加实现移植的数量。
While there is a growing need for kidney transplants to treat end stage kidney disease, the supply of transplantable kidneys is in serious shortage. Kidney paired donation (KPD) programs serve as platforms for candidates with willing but incompatible donors to assess the possibility of exchanging donors, thus opening up new transplant opportunities for these candidates. In recent years, non-directed (or altruistic) donors (NDDs) have been incorporated into KPD programs beginning chains of transplants that benefit many candidates. In such programs, making optimal decisions in transplant exchange selection is of critical importance. With the aim of improving the selection of chains beginning with an NDD, this paper introduces a look-ahead multiple decision strategy to select chains, that are easy to extend in the future. Simulation studies are adopted to assess performance of this strategy. Taking into account the extensibility of chains increases the number of realized transplants.