Liver Exchange

肝脏交换

• 批准号: 1729778
• 负责人: M. Utku Unver
• 金额: $ 29.17万
• 依托单位: Boston College
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1729778&HistoricalAwards=false
• 关键词: Liver; Exchange

Liver transplants can save the lives of people with liver failure, but the need for transplants exceeds the number of donors. As a result, lives can be saved if we find better ways to use all potential donors. This award funds research that builds on previous efforts to use economic theory to improve outcomes for transplant patients. The team will focus on new theories and methods that can be applied to the unique aspects of liver transplant from living donors. Donors have two lobes (left and right) and can donate one. The left lobe is smaller, and donating this lobe is less risky for the donor. However, the lobe must be large enough to support the recipient. Tissue compatibility is also an issue. Many willing donors either cannot donate to their loved one or can only do so by making a larger, riskier donation. The team wants to develop methods that will make it possible to match more patients with donors while also minimizing donor risks. The project will require new technical methods beyond previous work in organ (kidney) exchange. This project develops new ideas in economic theory and proposes specific methods that can be implemented in clearinghouses that can match donors with recipients. The award therefore has the potential to save lives.The project will proceed in several distinct stages. The first will consider the size compatibility issue assuming that each recipient is matched to one living donor. The second stage will model a medically feasible alternative: a recipient needing a large liver might be matched with two donors who each donate a small lobe. In this case the recipient receives two donor organs. The research team will first develop an exchange method assuming that each recipient has two loved ones who are willing to donate (at least one tissue incompatible) and will be matched with two donors. The third stage examines whether or not even better outcomes might be possible if unbalanced exchanges are allowed; that is, a patient may provide only one donor (with a large liver and therefore a large donation) and receive two small donations. The team will develop new theoretical tools in mechanism design, using discrete and continuum graphs with multi-dimensional lattice compatibility requirements to model size compatibility and blood type compatibility.

肝移植可以挽救肝功能衰竭患者的生命，但移植的需求超过了捐献者的数量。因此，如果我们找到更好的方法来利用所有潜在的捐助者，就可以挽救生命。该奖项资助基于之前利用经济理论改善移植患者预后的研究。该团队将重点研究可应用于活体捐献者肝移植独特方面的新理论和方法。捐赠者有两个肺叶（左和右），可以捐赠其中一个。左肺叶较小，捐赠该肺叶对捐赠者来说风险较小。然而，波瓣必须足够大以支撑接收者。组织相容性也是一个问题。 许多自愿捐赠者要么无法向亲人捐赠，要么只能通过数额更大、风险更大的捐赠来实现。该团队希望开发出一种方法，使更多的患者与捐赠者相匹配，同时最大限度地降低捐赠者的风险。该项目将需要超越以往器官（肾脏）交换工作的新技术方法。 该项目开发了经济理论中的新思想，并提出了可以在信息交换所中实施的具体方法，从而将捐助者与受助者进行匹配。因此，该奖项具有拯救生命的潜力。该项目将分几个不同的阶段进行。第一个将考虑尺寸兼容性问题，假设每个接受者与一个活体捐赠者相匹配。第二阶段将模拟一种医学上可行的替代方案：需要大肝脏的接受者可能会与两名捐献者相匹配，每个捐献者捐献一个小肝叶。在这种情况下，受者会收到两个捐赠器官。研究小组将首先开发一种交换方法，假设每个接受者有两个愿意捐赠的亲人（至少有一个组织不相容），并将与两个捐赠者进行匹配。第三阶段考察如果允许不平衡交换是否可能有更好的结果；也就是说，患者可能只提供一名捐赠者（肝脏较大，因此捐赠量较大）并接受两份小额捐赠。该团队将开发新的机制设计理论工具，使用具有多维晶格兼容性要求的离散图和连续图来建模尺寸兼容性和血型兼容性。

项目成果

Market design for living-donor organ exchanges: an economic policy perspective

活体器官交换的市场设计：经济政策视角

• DOI: 10.1093/oxrep/grx048
• 发表时间: 2017
• 期刊: Oxford Review of Economic Policy
• 影响因子: 6.8
• 作者: Sönmez, Tayfun;Ünver, M Utku
• 通讯作者: Ünver, M Utku