Organ transplantation logistics : case for Turkey

Abstract

Organ transplantation is one of the fundamental and effective treatment techniques for the patients who have critical health problems. However, while 3,930 organs were transplanted to the patients in 2011, there still exist 20,954 people waiting for a suitable organ as of April 2012 in Turkey. Even though the exact numbers are different; the situation of well developed countries like USA is not very different in terms of organ donation and patient ratio. Thus; matching - defined as finding the best recipient for a donated organ- is very crucial for the overall organ transplantation process. There are mainly two different ways of matching in the applications: centralized and hierarchical method. In the centralized method, all patients and donors are monitored and matching is coordinated centrally. In the hierarchical method, the matching process is coordinated via a bottom-up hierarchy. The application in Turkey is also hierarchical, coordinated by nine regional coordination centers and one national coordination center. Due to the nature of the matching application in Turkey, the cluster of each regional coordination center is crucial. There are many dynamics of the transplantation process like cold ischemia time -the duration that the organ survives without blood circulation-, operation times and specialized hospitals and teams. In this thesis, we study the organ transplantation logistics mainly focusing on the Turkish application. We provide mathematical models that consider the problem specific requirements like ischemia time. We also consider two-mode transportation since airplanes or helicopters are also used widely in organ transportation. Finally, we also developed a simulation model to observe the hierarchical nature of the system and to evaluate the performance of the mathematical model outputs. Both mathematical model and simulation model outcomes based on Turkish data were compared with actual regional coordination center locations of Turkey.