New Research Identifies a Way to Match Supply and Demand While Increasing Transplant Equity
INFORMS Journal Manufacturing & Service Operations Management New Study Key Takeaways:
- Matching supply and demand of organs can provide broader sharing in a way that results in greater transplant equity.
- By indiscriminately enlarging the pool of supply locations from where patients can receive offers, they tend to become more selective, resulting in more offer rejections and less efficiency.
- The model accounts for the variation of “incidence of disease” (i.e., demand) and “availability of deceased-donor organs” (i.e., supply) and allows for variations in how broadly a donor hospital shares its organs.
BALTIMORE – As it currently stands, U.S. policies around organ transplantation are moving toward broader sharing of organs, with the goal of improving geographic equity. It’s a great goal, but not being achieved. These policies have gone through two major modifications in the last 10 years, but to no avail. Now, researchers are introducing a new model in a paper published in the INFORMS journal Manufacturing & Service Operations Management, which recommends a more efficient and equitable method to allocate organs with a policy that balances the supply (deceased donors) to demand (waiting list patients) ratios across geographies.
"This method is better than the current U.S. policy (Acuity Circles) in achieving geographic equity while also improving efficiency,” says S. Raghavan of the University of Maryland.
“Policymakers should move away from the ‘one size-fits-all’ approach and focus on matching supply and demand to develop organ allocation policies that score well in terms of efficiency and geographic equity.”
In the study, “Improving Broader Sharing to Address Geographic Inequity in Liver Transplantation,” the model accurately predicts the change in a patient’s organ-offer acceptance probability due to a change in policy. The researchers used liver transplantation data from the Scientific Registry of Transplant Recipients (SRTR), which included information on all donors, waitlisted candidates and transplant recipients in the U.S. Based on their model’s predictions, the researchers concluded that broader sharing in its current form (i.e., Acuity Circles) may not be the best strategy to balance geographic equity and efficiency.
Raghavan, alongside his co-authors Shubham Akshat of Carnegie Mellon University and Liye Ma of the University of Maryland, says that by indiscriminately enlarging the pool of supply locations from where patients can receive offers, they tend to become more selective, resulting in more offer rejections and less efficiency.
“This model would account for the variation of ‘incidence of disease’ (i.e., demand) and ‘availability of deceased-donor organs’ (i.e., supply), and allow for variations in how broadly a donor hospital shares its organs (i.e., how far it will be shared),” says Akshat, a professor in the Tepper School of Business at CMU. “Although this may not sound immediately fair, it results in a policy with greater equity than the current transplant policy.”
The researchers argue that if the suggestions of this work are followed by the U.S. government, it is likely that the large differences that are seen in waiting times will diminish for organs across transplant centers across the country. Thus, access to deceased donor organs will be similar across transplant centers, making the system fairer for patients.
About INFORMS and Manufacturing & Service Operations Management
INFORMS is the leading international association for operations research and analytics professionals. Manufacturing & Service Operations Management, one of 17 journals published by INFORMS, is a premier academic journal that covers the production and operations management of goods and services including technology management, productivity and quality management, product development, cross-functional coordination, and practice-based research. More information is available at www.informs.org or @informs.
