Preface

Eight European countries participate in Eurotransplant, the international organ exchange organization situated in Leiden, the Netherlands. When a deceased organ donor becomes available in these countries, Eurotransplant’s role is to find suitable recipients for the donor’s organs. This allocation problem is not trivial, as more than 13,500 candidates are waiting for a transplant in 73 active transplantation programs. To facilitate the allocation process, Eurotransplant has implemented complex allocation systems, which include mechanisms that aim to give patients a fair chance of receiving a transplant.

In this thesis, we first examine whether Eurotransplant’s liver and kidney allocation systems are delivering such equality of opportunity to patients who are waiting for transplants. Our second objective is to develop simulation tools which can be used to quantify the impact of alternative allocation rules on waiting list outcomes in kidney and liver transplantation.

The cover of this thesis (see below) graphically illustrates Eurotransplant’s allocation problem, with kidney transplant centers labeled in blue, liver transplant centers in red, and transplant centers that perform both liver and kidney transplantations appearing in both colors. The size of the dots corresponds to the annual transplantation volume per center. The shading of the region corresponds to the number of donors available relative to an area’s population density. Regions shown in yellow, such as Belgium and Rijeka in Croatia, have the highest organ donation rates.

Cover of this thesis

The online version of this thesis is licensed under a Creative Commons Attribution 4.0 International License. The pdf version of the thesis is available for download on the toolbar above.

This PhD project was conducted under the supervision of Dr. Bart Smeulders and Prof. Dr. Frits Spieksma at Eindhoven University of Technology.

The research of H.C. de Ferrante and F.C.R. Spieksma was partly funded by the Netherlands Organization for Scientific Research (NWO) through Gravitation grant NETWORKS 024.002.003.