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. 2014 Jan;38(1):53-72.

Decision Making in Kidney Paired Donation Programs with Altruistic Donors

Yijiang Li, Peter X-K Song, Alan B Leichtman, Michael A Rees, John D Kalbfleisch

Decision Making in Kidney Paired Donation Programs with Altruistic Donors

Yijiang Li et al. Sort (Barc). 2014 Jan.

Abstract

In recent years, kidney paired donation (KPD) has been extended to include living non-directed or altruistic donors, in which an altruistic donor donates to the candidate of an incompatible donor-candidate pair with the understanding that the donor in that pair will further donate to the candidate of a second pair, and so on; such a process continues and thus forms an altruistic donor-initiated chain. In this paper, we propose a novel strategy to sequentially allocate the altruistic donor (or bridge donor) so as to maximize the expected utility; analogous to the way a computer plays chess, the idea is to evaluate different allocations for each altruistic donor (or bridge donor) by looking several moves ahead in a derived look-ahead search tree. Simulation studies are provided to illustrate and evaluate our proposed method.

Keywords: Altruistic donors; decision analysis; kidney paired donation; look-ahead search tree.

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Figures

Figure 1
Figure 1
(A): A two-way exchange; (B): A three-way exchange; (C): A NEAD chain.
Figure 2
Figure 2
(A): A graph representation of a KPD program with a two-way exchange cycle, where Vp={1,2} and E={(1,2),(2,1)}; (B): A graph representation of a KPD program with a three-way exchange cycle, where Vp={1,2,3} and E={(1,2),(2,3),(3,1)}; (C): A graph representation of a NEAD chain, where Va={1},Vp={2,3} and E={(1,2),(2,3)}; donor 3 at the end of the chain becomes a bridge donor.
Figure 3
Figure 3
(A): A KPD program G with one altruistic donor and four incompatible pairs as well as various subgraphs of G; (B): A standard decision tree analysis for a KPD program G as in (A), with squares representing decision nodes and circles indicating chance nodes; the decision node G3 (which is shaded) appears twice in the tree and hence is only drawn once.
Figure 4
Figure 4
A search tree-based analysis for a KPD program G.
See this image and copyright information in PMC

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