Can Harvard and MIT Make Organ Transplants More Efficient?

Posted by: Louis Lavelle on December 2, 2011

Business school professors at Harvard and MIT are using some of the same mathematical tools used by hedge funds to devise a new system for giving away donated organs.

In a working paper posted by the Harvard Business School, three researchers found that the life expectancies of transplant patients can be increased by up to 8 percent if quantitative tools are used to establish organ donation policies.

The paper focuses on the U.S. Department of Health and Human Services, which set out to revise its model for determining the priority order of donation recipients in 2004.

The current model is a point system that gives patients marks for how long they have been waiting for a transplant and how likely their body is to accept an available organ, says paper co-author Nikos Trichakis, an assistant professor at the Harvard Business School. A higher probability of organ acceptance means the transplant is more likely to be successful and the patient may live longer.

A criticism of the current system is that it doesn’t account for the fact that medical advances made over the last 20 years mean some patients were living longer while waiting for an organ. (The HBS and MIT paper specifically looked at kidney donations, where patients awaiting a transplant can survive on dialysis for years.) The long wait time for an organ may make those patients preferred candidates for transpalnts under the current system, regardless of the likelihood of their survival. In Trichakis’ view, it’s an inefficient system for allocating a resource in high demand and short supply.

"It is almost a first-come, first-serve system," he says. "Some people might think this system is fair, but there is no efficiency component to it. We're not making the best use of the organs."

Efficiency, according to the paper, means making sure the number of quality life years gained by transplantation is as high as possible.

If policy makers revise their organ-distribution model, they would create a new point system based on any number of variables, and that system may assign greater importance to indicators of survivability.

The business professors are clear that they are not providing guidance on what the point system's variables should be -- that would fall to policy makers. Their contribution, Trichakis notes, is the mathematical software that would compute the variables and give policy makers a working formula to produce the outcomes they decide on.

The research is part of a growing body of work where business professionals are using quantitative tools in areas where they haven't often used those tools before. In April, we wrote about the group Education Pioneers, which has recruited financial analysts to evaluate data sets such as student enrollment and retention, attendance patterns, and population estimates at K-12 schools so that the schools can operate more efficiently.

Trichakis says part of what drew him to research on organ donations was the ability to use quantitative methods in a different setting. "My research demonstrates how data-driven approaches and business analytics tools can actually be very powerful in those settings when they are combined with managerial expertise, or medical expertise, depending on the topic." he says.

--Erin Zlomek

Reader Comments

Howard

December 2, 2011 7:12 PM

The paper you refer to is based on a system for allocation of kidneys for transplant. The article generalizes and implies that this
Is the system utilized for all transplants. This is not the case. As a recipient of a donated pair of lungs, I know that the system now used for lung allocation is based on need with numerical values quantifying the need called a Lung Allocation Score ( LAS) not a first come first serve basis.

Dave Undis

December 3, 2011 8:26 AM

Organs should be allocated first to registered organ donors. This would create an incentive for non-donors to donate.

It would also make organ allocation fairer. Everyone can offer to donate, regardless of their medical condition or history, so those who aren't willing to donate should go to the back of the transplant waiting list.

If you'd like to donate your organs to other registered organ donors, you can join LifeSharers at www.lifesharers.org. Membership is free. By joining, you'll get preferred access to the organs of our other members should you ever need a transplant.

Dave Undis
Executive Director
LifeSharers

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