Matching lives--Reducing the waiting time in kidney paired donation

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Kidney transplant is a life-saving therapy for end stage renal disease, and directed living donation is one of the main sources of graft. However, it is often unavailable because the willing living donor is blood type or tissue type incompatible with the patient. Kidney Paired Donation (KPD) facilitates the exchanges among incompatible living donor-patient pairs to create opportunities for transplants. In this research, I focus on the waiting time in the KPD system. The large number of highly sensitized (hard-to-match) patients accumulated in the KPD system have considerably longer waiting time than the others, and have led to a sparsely connected compatibility graph. I show that this can negatively impact the chances for the otherwise easy-to-match patients. To address this issue, I constructed a model for the KPD system based on historical data, and examined the policy of assigning priorities using the structural knowledge of the compatibility graph. I demonstrated through simulation that when the hard-to-match pairs receive priorities their waiting time can be significantly reduced. Moreover, the prioritization of the hard-to-match pairs does not necessarily disadvantage the rest of the population. In fact, the overall waiting time can be reduced. Furthermore, using a model with uncertain match offer rejections, I quantified the imperfect information's impact on the system waiting time, and showed a need for improvement on the current implementation of KPD. Finally, I studied the prohibition clause in National Organ Transplant Act (42 U.S.C.§274e) that led to today's commonly practiced ban on human organ selling/purchasing. In doing so I pointed out that the original prohibition leaves room for interpretation, specifically regarding the validity of a contract regulating organ transplant: contrary to some's belief, it is possible that such a contract is valid and enforceable under NOTA.


Type of resource text
Form electronic; electronic resource; remote
Extent 1 online resource.
Publication date 2016
Issuance monographic
Language English


Associated with Liu, Wenhao
Associated with Stanford University, Department of Management Science and Engineering.
Primary advisor Howard, Ronald A. (Ronald Arthur), 1934-
Thesis advisor Howard, Ronald A. (Ronald Arthur), 1934-
Thesis advisor Melcher, Marc (Marc Lee)
Thesis advisor Shachter, Ross D
Advisor Melcher, Marc (Marc Lee)
Advisor Shachter, Ross D


Genre Theses

Bibliographic information

Statement of responsibility Wenhao Liu.
Note Submitted to the Department of Management Science and Engineering.
Thesis Thesis (Ph.D.)--Stanford University, 2016.
Location electronic resource

Access conditions

© 2016 by Wenhao Liu
This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).

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