Improving Organ Transplant Availability by Evaluating Risk of Infection Transmission
The demand and the average time on the waiting lists for organ transplants are growing, while the supply of organs remains comparatively limited.
According to UNOS, the United Network for Organ Sharing, currently more than 121,480 people across the United States are waiting for an organ, while 30,970 people received transplants in 2015. In the same year, 6,648 people died on the transplant waitlist, while 6,702 were removed from the list after waiting so long that they became too sick to undergo transplant surgery.
A possible resolution to this problem is to increase the availability of organs. In the past, organs with a small risk of infection were often not chosen for transplant. After several transmissions of infectious diseases that occurred through transplants where these infections (or the risk) were not detected ahead of time, use of many more organs were discouraged because of problems with understanding the risk.
A collaborative project between ISyE and the Centers for Disease Control and Prevention (CDC) addresses this issue of risk estimation and perception, with the goal of assessing the risk of infection in an organ donor, and evaluating the options of receiving an increased-risk donor (IRD) organ versus staying on the waitlist for a patient. Ultimately, the goals are to reduce deaths due to organ transplants transmitting infections, boost the availability of organs without infection for transplant, and reduce the number of patients who die while on the waiting list.
The collaboration started with a Senior Design project, initially focusing on infectious encephalitis in liver transplants.
Under the guidance of Pinar Keskinocak, ISyE’s William W. George Chair, and CDC subject matter experts (SMEs), the fall 2014 Senior Design team — Nishi Anand, Dylan Buczek, Nicholas Buczek, Timothy Lin, Tanay Rajore, and Muriel Wacker — developed two prototype tools to help physicians and their patients calculate the risk of infectious encephalitis and evaluate the benefits and risks of accepting IRD livers for transplant.
The collaboration has now grown into a $1,104,000 budgeted research project and includes a three- year, $651,000 grant from the Carlos and Marguerite Mason Trust. Joel Sokol, ISyE Fouts Family Associate Professor and Director of Georgia Tech’s interdisciplinary Master of Science in Analytics degree, is the principal investigator on the grant, along with co-investigators Keskinocak and a team of SMEs from the CDC. The ISyE/CDC team will enlarge the project’s scope to other organs and other infectious diseases such as HIV, Hepatitis B and C, as well as pathogens that cause encephalitis. The ISyE investigators will also study the possibility of increased organ sharing among Georgia facilities, to improve the in-state transplant system.
In the next year or two, statistical analysis of probabilities for transmission of infections compared with survival rates for liver, heart, kidney, and lung transplants will be completed. This will be followed by a pilot study of the currently in- development decision support tools in Georgia transplant centers.
In addition to the grant from the Carlos and Marguerite Mason Trust, Georgia Tech will also provide funds toward the project’s indirect costs, and the CDC has agreed to fund a percentage of in-kind work.