#11 Research meet-up: New US lung allocation policy projected to reduce waitlist mortality by over 20%

Nikolaos Trichakis presented an analytical framework developed with the Organ Procurement and Transplantation Network to explore trade-offs among organ-allocation policies. The resulting lung-allocation policy was approved for implementation across the United States in 2023 and was projected to reduce waitlist mortality by more than 20% compared with the previous policy.

Nikolaos (Nikos) Trichakis is the Associate Dean, Social and Ethical Responsibilities of Computing, MIT Schwarzman College of Computing and MIT Sloan, the J.C. Penney Professor of Management and a Professor of Operations Management at the MIT Sloan School of Management. His research interests include optimisation under uncertainty, data-driven optimisation and analytics, with applications in healthcare, supply chain management, and finance. Trichakis is also interested in the interplay of fairness and efficiency in resource allocation problems and operations, and the inherent tradeoffs that arise in balancing these objectives.

Why does organ allocation require trade-offs?

When a donor organ becomes available, allocation rules determine which patient should receive it.

These decisions need to balance different objectives, including medical need, expected outcomes and equitable access. Improving one objective can sometimes affect another, which means there may be no single policy that performs best on every measure.

Why is this a prescriptive analytics problem?

The project introduced a framework for dynamically exploring the efficient frontier of policy options.

An efficient frontier shows the set of choices where improving one objective would require giving up performance on another. This allows decision-makers to examine how changing allocation rules affects different outcomes instead of relying on a single preselected solution.

How did the analysis influence lung allocation?

The framework was applied jointly with the Organ Procurement and Transplantation Network (OPTN) to the design of a new US lung-allocation policy.

The policy was approved for implementation, and from 2023 all lungs in the United States have been allocated according to the new approach. Its expected effect was a greater than 20% reduction in waitlist mortality compared with the previous policy. This is a projected effect rather than a measured post-implementation outcome.

The work was developed jointly by Nikolaos Trichakis, Ted Papalexopoulos, Dimitris Bertsimas, James Alcorn, Rebecca Goff and Darren Stewart, together with OPTN.