论文标题
肾脏交换计划中已故捐赠者启动链的长期仿真分析
Long term simulation analysis of deceased donor initiated chains in kidney exchange programs
论文作者
论文摘要
已经开发了肾脏交换计划，以找到不兼容捐助者的接收者兼容肾脏。另一方面，没有活捐赠者的患者取决于已故捐赠者（DD）捐赠以进行肾脏移植。目前，在印度，死者的捐助者直接向已故的捐赠者候补名单捐赠了肾脏。在几篇文章中提出了从已故捐赠者肾脏开始的交换链（最近在意大利执行）的想法，但没有为此合并提供数学表述。我们引入了一个整数编程公式，该公式会创建已故的捐赠者启动链条，同时考虑了配对的交换注册表和已故的捐助者分配。配对的交换注册表与已故捐赠者等待名单注册表数据之间有可能重叠，因为收件人可以独立注册两个注册表。本文也已经解决了这一点。进行了一项长期仿真研究，以分析这些DD启动链的增益。这表明即使有少数已故捐助者，这些链也可以大大增加潜在移植的数量。此外，合并注册表中的等待时间和辍学率大大降低。
Kidney exchange programs have been developed to find compatible kidneys for recipients who have incompatible donors. On the other hand, patients who do not have a living donor depend upon deceased donor (DD) donations to get a kidney transplant. Currently, in India a deceased donor donates kidneys directly to a deceased donor wait-list. The idea of initiating an exchange chain starting from a deceased donor kidney is proposed in a few articles (and recently executed in Italy), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates deceased donor initiated chains, considering both paired exchange registry and deceased donor allocations simultaneously. There is a possibility of overlap between paired exchange registry and deceased donor wait-list registry data as recipients can register for both registries independently. This has also been addressed in the paper. A long term simulation study is done to analyze the gain of these DD initiated chains over time. It suggests that even with small numbers of deceased donors, these chains can increases the number of potential transplants significantly. Also, waiting time and dropout rates in the merged registry decreases substantially.
