Simulation of Kidney Paired Donation Programs

• Activity Number: 259
• Type: Contributed
• Date/Time: Monday, August 2, 2010 : 2:00 PM to 3:50 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Yijiang (John) Li*+ and Yan Zhou and John David Kalbfleisch and Peter Song
• Companies: University of Michigan and University of Michigan and University of Michigan and University of Michigan
• Keywords: Kidney Paired Donation ; Simulation Models ; Optimal Exchange ; Expected Utility ; Integer Programming

Abstract

Kidney paired donation (KPD) programs provide an important platform for living incompatible donor/recipient pairs to exchange organs to achieve mutual benefit. Our innovative simulation utilizes empirically based models of donor and recipient characteristics and arrival patterns to a KPD program and explicitly takes into consideration outcome based and rule based utilities (e.g. allograft survival or life years gained from transplant); in addition, it models probabilities that a chosen exchange will actually be implemented. We develop a new strategy that is able to exploit possible alternative transplants that might be performed when a planned exchange fails. Optimal exchanges can be obtained using integer programming techniques and simulation models allow tracking of the KPD over a series of match runs to evaluate various utilities and strategies. Some example simulations are given.