Maximizing expected number of transplants in kidney exchange programs

2016 ◽  
Vol 52 ◽  
pp. 269-276 ◽  
Author(s):  
Filipe Alvelos ◽  
Xenia Klimentova ◽  
Abdur Rais ◽  
Ana Viana
Author(s):  
Bart Smeulders ◽  
Valentin Bartier ◽  
Yves Crama ◽  
Frits C. R. Spieksma

We introduce the problem of selecting patient-donor pairs in a kidney exchange program to undergo a crossmatch test, and we model this selection problem as a two-stage stochastic integer programming problem. The optimal solutions of this new formulation yield a larger expected number of realized transplants than previous approaches based on internal recourse or subset recourse. We settle the computational complexity of the selection problem by showing that it remains NP-hard even for maximum cycle length equal to two. Furthermore, we investigate to what extent different algorithmic approaches, including one based on Benders decomposition, are able to solve instances of the model. We empirically investigate the computational efficiency of this approach by solving randomly generated instances and study the corresponding running times as a function of maximum cycle length, and of the presence of nondirected donors. Summary of Contribution: This paper deals with an important and very complex issue linked to the optimization of transplant matchings in kidney exchange programs, namely, the inherent uncertainty in the assessment of compatibility between donors and recipients of transplants. Although this issue has previously received some attention in the optimization literature, most attempts to date have focused on applying recourse to solutions selected within restricted spaces. The present paper explicitly formulates the maximization of the expected number of transplants as a two-stage stochastic integer programming problem. The formulation turns out to be computationally difficulty, both from a theoretical and from a numerical perspective. Different algorithmic approaches are proposed and tested experimentally for its solution. The quality of the kidney exchanges produced by these algorithms compares favorably with that of earlier models.


Math Horizons ◽  
2010 ◽  
Vol 18 (1) ◽  
pp. 26-29
Author(s):  
Olivia M. Carducci

2018 ◽  
Vol 102 ◽  
pp. S508
Author(s):  
Bernadette J.J.M. Haase-Kromwijk ◽  
Aline Hemke ◽  
Peter Biró ◽  
Lisa Burnapp ◽  
Rachel Johnson ◽  
...  

2019 ◽  
Vol 87 (3) ◽  
pp. 1091-1133 ◽  
Author(s):  
Tommy Andersson ◽  
Jörgen Kratz

Abstract Advances in medical technology have made kidney transplants over the blood group barrier feasible. This article investigates how such technology should be implemented when designing pairwise kidney exchange programs. The possibility to receive a kidney transplant from a blood group incompatible donor motivates an extension of the preference domain, allowing patients to distinguish between compatible donors and half-compatible donors (i.e. blood group incompatible donors that only become compatible after undergoing an immunosuppressive treatment). It is demonstrated that the number of transplants can be substantially increased by providing an incentive for patients with half-compatible donors to participate in kidney exchange programs. The results also suggest that the technology is beneficial for patient groups that are traditionally disadvantaged in kidney exchange programs (e.g. blood group O patients). The positive effect of allowing transplants over the blood group barrier is larger than the corresponding effects of including altruistic patient–donor pairs or of allowing three-way exchanges in addition to pairwise exchanges.


2009 ◽  
Vol 01 (04) ◽  
pp. 499-517 ◽  
Author(s):  
PÉTER BIRÓ ◽  
DAVID F. MANLOVE ◽  
ROMEO RIZZI

Centralized matching programs have been established in several countries to organize kidney exchanges between incompatible patient-donor pairs. At the heart of these programs are algorithms to solve kidney exchange problems, which can be modelled as cycle packing problems in a directed graph, involving cycles of length 2, 3, or even longer. Usually, the goal is to maximize the number of transplants, but sometimes the total benefit is maximized by considering the differences between suitable kidneys. These problems correspond to computing cycle packings of maximum size or maximum weight in directed graphs. Here we prove the APX-completeness of the problem of finding a maximum size exchange involving only 2-cycles and 3-cycles. We also present an approximation algorithm and an exact algorithm for the problem of finding a maximum weight exchange involving cycles of bounded length. The exact algorithm has been used to provide optimal solutions to real kidney exchange problems arising from the National Matching Scheme for Paired Donation run by NHS Blood and Transplant, and we describe practical experience based on this collaboration.


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