Eliminating Waiting Time Inequities for Deceased Donor Kidney Transplantation in the USA

Abstract

Inequities in deceased donor organ transplantation wait times have received considerable attention in the scientific literature over the last three decades and have motivated allocation policy reforms. This holds particularly true for kidney transplantation in the United States, where more than 90.000 patients are waitlisted and waiting times vary considerably among patients from different blood types and ethnicities. This research formally models, analyzes and maximizes equity of transplant waiting times and probabilities using queuing theory and network flows, based on Rawls' theory of justice. The presented formal models address inequities resulting from blood type incompatibilities, which are interrelated to ethnic differences in patient and donor rates. We derive general methods to characterize and resolve these inequities. Moreover, for deceased donor kidney allocation in the USA, our results indicate that the policies currently practiced broadly suffice to resolve ethnic and blood type inequalities and inequities in so far as caused by blood type incompatibilities.

Brief Biography

Joris van de Klundert (1967) holds an MSc in Management Informatics from Erasmus University Rotterdam and a Ph.D. in Operations Research from Maastricht University. For Maastricht University he co-founded university spin-off company Mateum, and the Venlo Campus, and served as a full professor of Value Chain Optimization from 2007-2008. From 2009 to 2017 he served as chair of the Department of Health Services Management at Erasmus University Rotterdam, and as Vice Dean of Education of the Erasmus School for Health Policy.