Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System

Previous researchers have modelled the decision to accept a donor organ for transplantation as a Markov decision problem, the solution to which is often a control-limit optimal policy: accept any organ whose match quality exceeds some health-dependent threshold; otherwise, wait for another. When competing transplant centers vie for the same organs, the decision rule changes relative to no competition; the relative size of competing centers affects the decision rules as well. Using center-specific graft and patient survival-rate data for cadaveric adult livers in the United States, we have found empirical evidence supporting these predictions.