Optimizing the effectiveness of Organ Allocation 117 Optimizing the Effectiveness of Organ Allocation Matthew rognlie eng Amy Wen Duke University Durham, Nc Advisor: David Kraines Introduction The first successful organ transplant occurred in 1954, a kidney transplan etween twin brothers in Boston [Woodford 2004]. Since then, although the number of transplants per year has steadily risen, the number of organ donors has not kept up with demand [Childress and Liverman 2006](Figure 1) To ensure equitable distribution of available organs, Congress passed the National Organ Transplant Act in 1984. The act established the Organ Pro- curement and Transplantation Network(OPTN), a regionalized network for organ distribution [Conover and Zeitler 2006]. In 2000, the U.S. Department of Health and Human Services(HHS)implemented a additional policy called the Final Rule, which ensured that states could not interfere with OptN policies that require organ sharing across state lines [Organ Procurement.. 1999] The organ matching process involves many factors, whose relative im tance depends on the type of organ involved. These include compatibility,re- gion, age, urgency of patient, and waitlist time [Organ Procurement.. 2006 though most countries use the same basic matching processes, systems var in their emphasis on particular parameters [Transplantation Society..2002; UK Transplant 2007; Doxiadis et al. 2004; De Meester et al. 1998]1 In 2006, kidneys comprised 59% of all organs transplanted [Organ Procure- ment..2007]. In determining compatibility in kidney transplants, doctor look a ABo blood type: The aBo blood type indicates the presence of two types of antigens, A and B, present in the patient's body. Antigens are foreign molecules or substances that triggeranimmuneresponse. People with blood The UMAP Journal28(2)(2007)117-138. Copyright 2007 by COMAP, Inc. Allrights reserved Permission to make digital or hard copies of part or all of this work for personal or classroom use ad wanted without fee provided that copies are not made or distributed for profit or commercialOptimizing the Effectiveness of Organ Allocation Optimizing the Effectiveness of Organ Allocation Matthew Rogniie Peng Shi Amy Wen Duke University Durham, NC Advisor: David Kraines Introduction The first successful organ transplant occurred in 1954,a kidnej, transplant between twin brothers in Boston [Woodford 2004]. Since then, although the number of transplants per year has steadily risen, the number of organ donors has not kept up with demand [Childress and Liverman 2006] (Figure 1). To ensure equitable distribution of available organs, Congress passed the National Organ Transplant Act in 1984. The act established the Organ Pro-' curement and Transplantation Network (OPTN), a regionalized network for organ distribution [Conover and Zeitler 2006]. In 2000, the U.S. Department of Health and Human Services (HHS) implemented a additional policy called the Final Rule, which ensured that states could not interfere with OPTN policies that require organ sharing across state lines [Organ Procurement... 1999]. The organ matching .process involves many factors, whose relative impor￾tance depends on the type of organ involved. These include compatibility, re￾gion, age, urgency of patient, and waitlist time [Organ Procurement... 2006]. Although most countries use the same basic matching processes, systems vary in their emphasis on particular parameters [Transplantation Society ... 2002; UK Transplant 2007; Doxiadis et al. 2004; De Meester et al. 1998]. In 2006, kidneys comprised 59% of all organs transplanted [Organ Procure￾ment ... 2007]. In determining compatibility in kidney transplants, doctors look at: * ABO blood type: The ABO blood type indicates the presence of two types of antigens, A and B, present in the patient's body. Antigens are foreign molecules or substances that trigger an immune response. People withblood The UMAPJournal28(2) (2007) 117-138. @Copyright2007by COMAP, Inc. All rights reserved. Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice. Abstracting with credit is permitted, but copyrights for components of this work owned by others than COMAP must be honored. To copy otherwise, to republish, to post on servers, or to redistribute to lists requires prior permission from COMAR 117