Ensuring Equitable Access to Liver Transplant Using Linear Programming Duality, Network Flow, and Simulation
Abstract
Donor livers are allocated via the Model for End-Stage Liver Disease (MELD) score. Women are consistently 4.8 less likely to receive a liver transplant than men. Women are disadvantaged by their smaller abdominal cavities which cannot accommodate larger donated livers. They are also disadvantaged by lower natural creatinine levels, a waste product correlated with liver disease. We proposed increasing female MELD scores to reach an equitable allocation of livers. To decide how many points should be added, we created a linear program to model liver allocation. This linear program used transplant data to test how total MELD points and total number of lives saved changes when a new constraint to enforce equity is introduced. Next, we used the linear programming duality theorem to calculate how many points should be added to female MELD scores. We then designed a network flow model to capture the size incompatibilities that women face when they are only able to accept small livers. We used data analysis to decide how to restrict the flow of livers between small donors and large patients and created new allocation rules reserving smaller livers for smaller patients to equalize the rate of transplant between all size groups.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 16, 2022
- Accession Number
- AD1171883
Entities
People
- Sarah G. Sorensen
Organizations
- United States Naval Academy