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  • 2011
  • Working Paper
  • HBS Working Paper Series

Fairness, Efficiency and Flexibility in Organ Allocation for Kidney Transplantation

By: Dimitris Bertsimas, Vivek F. Farias and Nikolaos Trichakis
  • Format:Print
  • | Language:English
  • | Pages:47
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Abstract

We propose a scalable, data-driven method for designing national policies for the allocation of deceased donor kidneys to patients on a waiting list, in a fair and efficient way. We focus on policies that have the same form as the one currently used in the U.S. In particular, we consider policies that are based on a point system, which ranks patients according to some priority criteria, e.g., waiting time, medical urgency, etc., or a combination thereof. Rather than making specific assumptions about fairness principles or priority criteria, our method offers the designer the flexibility to select his desired criteria and fairness constraints from a broad class of allowable constraints. The method then designs a point system that is based on the selected priority criteria, and approximately maximizes medical efficiency, i.e., life year gains from transplant, while simultaneously enforcing selected fairness constraints. Among the several case studies we present employing our method, one case study designs a point system that has the same form, uses the same criteria and satisfies the same fairness constraints as the point system that was recently proposed by U.S. policymakers. In addition, the point system we design delivers an 8% increase in extra life year gains. We evaluate the performance of all policies under consideration using the same statistical and simulation tools and data as the U.S. policymakers use. Other case studies perform a sensitivity analysis (for instance, demonstrating that the increase in extra life year gains by relaxing certain fairness constraints can be as high as 30%), and also pursue the design of policies targeted specifically at remedying criticisms leveled at the recent point system proposed by U.S. policymakers.

Keywords

Fairness; Policy; Health Disorders; Marketplace Matching; Performance Effectiveness; Rank and Position; Health Industry; United States

Citation

Bertsimas, Dimitris, Vivek F. Farias, and Nikolaos Trichakis. "Fairness, Efficiency and Flexibility in Organ Allocation for Kidney Transplantation." Harvard Business School Working Paper, No. 12-025, October 2011.
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More from the Authors
  • Slowly Varying Regression Under Sparsity By: Dimitris Bertsimas, Vassilis Digalakis Jr, Michael Lingzhi Li and Omar Skali Lami
  • Forecasting COVID-19 and Analyzing the Effect of Government Interventions By: Michael Lingzhi Li, Hamza Tazi Bouardi, Omar Skali Lami, Thomas Trikalinos, Nikolaos Trichakis and Dimitris Bertsimas
  • Data-Driven COVID-19 Vaccine Development for Janssen By: Dimitris Bertsimas, Michael Lingzhi Li, Xinggang Liu, Jennings Xu and Najat Khan
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