期刊
MANAGEMENT SCIENCE
卷 50, 期 10, 页码 1420-1430出版社
INFORMS
DOI: 10.1287/mnsc.1040.0287
关键词
medical decision making; Markov decision processes; control-limit policy; organ transplantation; liver transplantation; service operations
Living donors are a significant and increasing source of livers for transplantation, mainly because of the insufficient supply of cadaveric organs. We consider the problem of optimally timing a living-donor liver transplant to maximize the patient's total reward, such as quality-adjusted life expectancy. We formulate a Markov decision process (MDP) model in which the state of the process is described by patient health. We derive structural properties of the MDP model, including a set of intuitive conditions that ensure the existence of a control-limit optimal policy We use clinical data in our computational experiments, which show that the optimal policy is typically of control-limit type.
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