RAPID: Addressing Geographic Disparities in the National Organ Transplant Network

RAPID：解决国家器官移植网络中的地理差异

• 批准号: 1743886
• 负责人: Sanjay Mehrotra
• 金额: $ 10万
• 依托单位: Northwestern University at Chicago
• 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: 2017-07-15 至 2019-06-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1743886&HistoricalAwards=false
• 关键词: RAPID; Addressing; Geographic; Disparities; National

Liver transplantation is currently the only known medical treatment for End-stage Liver Disease with established survival benefits. In the United States, current allocation policies continue to result in geographical disparities for donor organs on several metrics. Disparities include the fraction of waitlisted patients dying on the waitlist, and the sickness level at which patients are transplanted in different areas of the country. This Rapid Response Research (RAPID) award supports refinements and enhancements to a novel neighborhood-based organ allocation approach currently being considered for adoption by policy makers on the United Network for Organ Sharing (UNOS) Liver and Intestine Committee. The refinements specifically address reducing geographic disparities by better matching donor organs with transplant beneficiaries. This award will provide decision support to UNOS and the broader transplantation community in the U.S.This RAPID award will support activities to take to scale the previously developed optimization model by utilizing national datasets. Because the model involves a highly complex multi-objective optimization, a refinement of the existing model is highly challenging, as identifying acceptable solutions involves lengthy simulations and manipulation of several parameters and structural linkages between organ procurement organizations. The simulation tools will be publicly available, and the data collected from an improved model is expected to have an impact on a broad population segment. Researchers in operations research, management science, transplant surgery, and the hepatology communities will be educated through presentation at national conferences. A graduate student will be trained as part of the research, and clinicians will also be educated as to the role of a scientific modeling approach when considering public health challenges.

肝移植是目前已知的唯一对终末期肝病有明确生存益处的内科治疗方法。在美国，目前的分配政策继续导致捐赠器官在几个指标上的地理差异。差异包括等待名单上的患者死亡的比例，以及在该国不同地区移植患者的疾病水平。这一快速反应研究(RAPID)奖支持对一种新的基于社区的器官分配方法的改进和增强，该方法目前正在考虑由器官共享联合网络(UNOS)肝脏和肠道委员会的政策制定者采用。这些改进具体解决了通过更好地将捐赠器官与移植受益人相匹配来缩小地理差异的问题。这一奖项将为联合国操作系统和美国更广泛的移植社区提供决策支持。这一快速奖项将支持通过利用国家数据集来扩大以前开发的优化模型所采取的活动。由于该模型涉及高度复杂的多目标优化，改进现有模型极具挑战性，因为确定可接受的解决方案涉及对几个参数以及器官采购组织之间的结构联系进行冗长的模拟和处理。模拟工具将向公众开放，从改进的模型收集的数据预计将对广泛的人口部分产生影响。运筹学、管理科学、移植外科和肝病社区的研究人员将通过在国家会议上发表演讲来接受教育。一名研究生将作为研究的一部分接受培训，临床医生也将接受关于科学建模方法在考虑公共卫生挑战时的作用的教育。

项目成果

LivSim: An Open-Source Simulation Software Platform for Community Research and Development for Liver Allocation Policies

LivSim：用于肝脏分配政策社区研究和开发的开源模拟软件平台

• DOI: 10.1097/tp.0000000000002000
• 发表时间: 2018
• 期刊: Transplantation
• 影响因子: 6.2
• 作者: Kilambi, Vikram;Bui, Kevin;Mehrotra, Sanjay
• 通讯作者: Mehrotra, Sanjay

A Concentric Neighborhood Solution to Disparity in Liver Access That Contains Current UNOS Districts

• DOI: 10.1097/tp.0000000000001934
• 发表时间: 2018-02-01
• 期刊: TRANSPLANTATION
• 影响因子: 6.2
• 作者: Mehrotra, Sanjay;Kilambi, Vikram;Klintmalm, Goran B.
• 通讯作者: Klintmalm, Goran B.