Accept or Decline? An Analytics-Based Decision Tool for Kidney Offer Evaluation

Transplantation
Dimitris BertsimasParsia A Vagefi

Abstract

When a deceased-donor kidney is offered to a waitlisted candidate, the decision to accept or decline the organ relies primarily upon a practitioner's experience and intuition. Such decisions must achieve a delicate balance between estimating the immediate benefit of transplantation and the potential for future higher-quality offers. However, the current experience-based paradigm lacks scientific rigor and is subject to the inaccuracies that plague anecdotal decision-making. A data-driven analytics-based model was developed to predict whether a patient will receive an offer for a deceased-donor kidney at Kidney Donor Profile Index thresholds of 0.2, 0.4, and 0.6, and at timeframes of 3, 6, and 12 months. The model accounted for Organ Procurement Organization, blood group, wait time, DR antigens, and prior offer history to provide accurate and personalized predictions. Performance was evaluated on data sets spanning various lengths of time to understand the adaptability of the method. Using United Network for Organ Sharing match-run data from March 2007 to June 2013, out-of-sample area under the receiver operating characteristic curve was approximately 0.87 for all Kidney Donor Profile Index thresholds and timeframes considered f...Continue Reading

References

Feb 5, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L M KucirkaD L Segev
Jan 30, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A J MatasB L Kasiske
Mar 18, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Michael L VolkKerby Shedden
Jan 13, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A HartA K Israni

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Citations

Apr 20, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Andrew WeyJon J Snyder
Jun 24, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Sunjae BaeJacqueline M Garonzik Wang
Jul 20, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Kevin BuiSanjay Mehrotra
Jun 24, 2017·Transplantation·Germaine WongJean Yang
Feb 20, 2021·Transplantation Proceedings·Ildikó NagyBalázs Nemes

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