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KPDGUI:一个用于虚拟肾配对捐赠计划优化和管理的交互式应用程序。

KPDGUI: An interactive application for optimization and management of a virtual kidney paired donation program.

机构信息

University of Michigan, Department of Biostatistics, Ann Arbor, MI, USA; University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, MI, USA.

University of Michigan, Department of Biostatistics, Ann Arbor, MI, USA; University of Michigan, Kidney Epidemiology and Cost Center, Ann Arbor, MI, USA.

出版信息

Comput Biol Med. 2019 May;108:345-353. doi: 10.1016/j.compbiomed.2019.03.013. Epub 2019 Mar 16.

Abstract

BACKGROUND AND OBJECTIVES

The aim in kidney paired donation (KPD) is typically to maximize the number of transplants achieved through the exchange of donors in a pool comprising incompatible donor-candidate pairs and non-directed (or altruistic) donors. With many possible options in a KPD pool at any given time, the most appropriate set of exchanges cannot be determined by simple inspection. In practice, computer algorithms are used to determine the optimal set of exchanges to pursue. Here, we present our software application, KPDGUI (Kidney Paired Donation Graphical User Interface), for management and optimization of KPD programs.

METHODS

While proprietary software platforms for managing KPD programs exist to provide solutions to the standard KPD problem, our application implements newly investigated optimization criteria that account for uncertainty regarding the viability of selected transplants and arrange for fallback options in cases where potential exchanges cannot proceed, with intuitive resources for visualizing alternative optimization solutions.

RESULTS

We illustrate the advantage of accounting for uncertainty and arranging for fallback options in KPD using our application through a case study involving real data from a paired donation program, comparing solutions produced under different optimization criteria and algorithmic priorities.

CONCLUSIONS

KPDGUI is a flexible and powerful tool for offering decision support to clinicians and researchers on possible KPD transplant options to pursue under different user-specified optimization schemes.

摘要

背景与目的

在肾脏配对捐赠(KPD)中,目标通常是通过在一个由不相容供体-候选对和非定向(或利他主义)供体组成的池中共享供体,最大限度地增加实现的移植数量。在任何给定时间的 KPD 池中都有许多可能的选择,因此,最适合的交换集不能通过简单的检查来确定。在实践中,使用计算机算法来确定要追求的最佳交换集。在这里,我们介绍了我们的软件应用程序 KPDGUI(肾脏配对捐赠图形用户界面),用于管理和优化 KPD 计划。

方法

虽然存在专有的 KPD 程序管理软件平台来提供标准 KPD 问题的解决方案,但我们的应用程序实现了新研究的优化标准,这些标准考虑了选定移植的可行性方面的不确定性,并在潜在交换无法进行的情况下安排备用选项,同时提供直观的资源来可视化替代优化解决方案。

结果

我们通过一个涉及配对捐赠计划真实数据的案例研究,使用我们的应用程序说明了在 KPD 中考虑不确定性和安排备用选项的优势,比较了在不同优化标准和算法优先级下生成的解决方案。

结论

KPDGUI 是一种灵活且强大的工具,可为临床医生和研究人员提供有关在不同用户指定的优化方案下可能追求的 KPD 移植选项的决策支持。

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本文引用的文献

2
3
An economic assessment of contemporary kidney transplant practice.当代肾移植实践的经济评估。
Am J Transplant. 2018 May;18(5):1168-1176. doi: 10.1111/ajt.14702. Epub 2018 Mar 31.
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A Kidney Exchange Clearinghouse in New England.新英格兰的肾脏交换信息中心。
Am Econ Rev. 2005 May;95(2):376-80. doi: 10.1257/000282805774669989.
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New Challenges in Multihospital Kidney Exchange.
Am Econ Rev. 2012 May;102(3):354-9. doi: 10.1257/aer.102.3.354.

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