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Statistics in Biosciences

, Volume 10, Issue 1, pp 255–279 | Cite as

Valuing Sets of Potential Transplants in a Kidney Paired Donation Network

  • Mathieu Bray
  • Wen Wang
  • Peter X.-K. Song
  • John D. Kalbfleisch
Article
  • 74 Downloads

Abstract

In kidney paired donation (KPD), incompatible donor–candidate pairs and non-directed (also known as altruistic) donors are pooled together with the aim of maximizing the total utility of transplants realized via donor exchanges. We consider a setting in which disjoint sets of potential transplants are selected at regular intervals, with fallback options available within each proposed set in the case of individual donor, candidate, or match failure. We develop methods for calculating the expected utility for such sets under a realistic probability model for the KPD. Exact expected utility calculations for these sets are compared to estimates based on Monte Carlo samples of the underlying network. Models and methods are extended to include transplant candidates who join KPD with more than one incompatible donor. Microsimulations demonstrate the superiority of accounting for failure probability and fallback options, as well as candidates joining with additional donors, in terms of realized transplants and waiting time for candidates.

Keywords

Kidney paired donation Organ exchanges Expected utility Network analysis Fallback options Waiting time 

Notes

Acknowledgements

This research was supported by the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) through Grant Number R01-DK093513. We thank the editor and reviewer for their careful reading of the manuscript and their helpful comments and suggestions.

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Copyright information

© International Chinese Statistical Association 2018

Authors and Affiliations

  1. 1.Department of BiostatisticsUniversity of MichiganAnn ArborUSA
  2. 2.Kidney Epidemiology and Cost CenterUniversity of MichiganAnn ArborUSA

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