{"id":{"repo_id":"vt","oai_identifier":"oai:vtechworks.lib.vt.edu:10919/137649"},"canonical_url":"https://search.dev.ndltd.org/etd/vt/oai:vtechworks.lib.vt.edu:10919/137649","repository":{"repo_id":"vt","name":"Virginia Tech","base_url":"https://vtechworks.lib.vt.edu/oai/request"},"display":{"title":"Targeted Priority Mechanisms in Organ Transplantation","abstract":"The persistent shortage of transplantable organs, compounded by high rates of organ underutilization, necessitates innovative allocation mechanisms. This dissertation develops and analyzes targeted priority mechanisms, voluntary incentive-based programs designed to enhance access for disadvantaged patient groups and improve organ-recipient matching. Using a rigorous queueing-theoretic framework, I characterize patients' equilibrium participation strategies, identifying conditions under which no-, full-, and mixed-participation equilibria emerge. I further establish the necessary and sufficient conditions for their existence and uniqueness, highlighting how careful mechanism design can align individual incentives with socially optimal outcomes. The study extends the analysis to class-separating allocations, demonstrating the feasibility of equilibria that improve social welfare while safeguarding non-participating patients' access to high-quality organs. A clinically detailed simulation of the U.S. kidney allocation system, focusing on elderly patients, illustrates the potential benefits: a targeted threshold of 84% KDPI yields approximately 220 additional annual transplants, reduces the waiting list by more than 450 patients, and prevents over 60 pre-transplant deaths annually, with minimal impact on graft survival rates. Overall, the findings provide both theoretical and practical guidance for the design of efficient, implementable allocation mechanisms.","abstract_html":"The persistent shortage of transplantable organs, compounded by high rates of organ underutilization, necessitates innovative allocation mechanisms. This dissertation develops and analyzes targeted priority mechanisms, voluntary incentive-based programs designed to enhance access for disadvantaged patient groups and improve organ-recipient matching. Using a rigorous queueing-theoretic framework, I characterize patients' equilibrium participation strategies, identifying conditions under which no-, full-, and mixed-participation equilibria emerge. I further establish the necessary and sufficient conditions for their existence and uniqueness, highlighting how careful mechanism design can align individual incentives with socially optimal outcomes. The study extends the analysis to class-separating allocations, demonstrating the feasibility of equilibria that improve social welfare while safeguarding non-participating patients' access to high-quality organs. A clinically detailed simulation of the U.S. kidney allocation system, focusing on elderly patients, illustrates the potential benefits: a targeted threshold of 84% KDPI yields approximately 220 additional annual transplants, reduces the waiting list by more than 450 patients, and prevents over 60 pre-transplant deaths annually, with minimal impact on graft survival rates. 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This dissertation develops and analyzes targeted priority mechanisms, voluntary incentive-based programs designed to enhance access for disadvantaged patient groups and improve organ-recipient matching. Using a rigorous queueing-theoretic framework, I characterize patients' equilibrium participation strategies, identifying conditions under which no-, full-, and mixed-participation equilibria emerge. I further establish the necessary and sufficient conditions for their existence and uniqueness, highlighting how careful mechanism design can align individual incentives with socially optimal outcomes. The study extends the analysis to class-separating allocations, demonstrating the feasibility of equilibria that improve social welfare while safeguarding non-participating patients' access to high-quality organs. A clinically detailed simulation of the U.S. kidney allocation system, focusing on elderly patients, illustrates the potential benefits: a targeted threshold of 84% KDPI yields approximately 220 additional annual transplants, reduces the waiting list by more than 450 patients, and prevents over 60 pre-transplant deaths annually, with minimal impact on graft survival rates. Overall, the findings provide both theoretical and practical guidance for the design of efficient, implementable allocation mechanisms."]},{"key":"dc:description.abstractgeneral","label":"General Abstract","values":["Every year, thousands of patients die while waiting for a life-saving organ transplant, even though many donated organs never get used. This research looks at how to make organ allocation fairer and more effective by introducing what are called targeted priority programs. These programs give certain groups of patients, such as older adults, earlier access to organs that are less likely to be used otherwise. In return, these patients give up priority for the highest-quality organs, making it easier to match every organ with the patient who can benefit most. The study shows how patients might respond to such programs, and how the rules can be designed to encourage participation without disadvantaging those who are not eligible. A detailed computer model of the U.S. kidney transplant system suggests that, with the right design, targeted priority programs could prevent more than 60 deaths each year, reduce the waiting list by over 450 patients, and add about 220 extra transplants annually—all while keeping transplant success rates nearly the same. Although no policy is perfect, this approach offers a promising way to make better use of donated organs and give more patients a second chance at life. By carefully choosing which patient groups to include and how to balance trade-offs, policymakers could create a system that is both more efficient and more equitable."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Doctor of Philosophy"]},{"key":"dc:format.medium","label":"Dc Format Medium","values":["ETD"]},{"key":"dc:title","label":"Title","values":["Targeted Priority Mechanisms in Organ Transplantation"]}]}],"canonical_facts":{"dc:contributor.committeechair":["Tunc, Sait"],"dc:contributor.committeemember":["Ellis, Matthew Jay","Bansal, Manish","Zhong, Huaiyang"],"dc:contributor.department":["Industrial and Systems Engineering"],"dc:creator":["Wang, Ruochen"],"dc:date.accessioned":["2025-09-09T08:02:10Z"],"dc:date.available":["2025-09-09T08:02:10Z"],"dc:date.issued":["2025-09-08"],"dc:description.abstract":["The persistent shortage of transplantable organs, compounded by high rates of organ underutilization, necessitates innovative allocation mechanisms. This dissertation develops and analyzes targeted priority mechanisms, voluntary incentive-based programs designed to enhance access for disadvantaged patient groups and improve organ-recipient matching. Using a rigorous queueing-theoretic framework, I characterize patients' equilibrium participation strategies, identifying conditions under which no-, full-, and mixed-participation equilibria emerge. I further establish the necessary and sufficient conditions for their existence and uniqueness, highlighting how careful mechanism design can align individual incentives with socially optimal outcomes. The study extends the analysis to class-separating allocations, demonstrating the feasibility of equilibria that improve social welfare while safeguarding non-participating patients' access to high-quality organs. A clinically detailed simulation of the U.S. kidney allocation system, focusing on elderly patients, illustrates the potential benefits: a targeted threshold of 84% KDPI yields approximately 220 additional annual transplants, reduces the waiting list by more than 450 patients, and prevents over 60 pre-transplant deaths annually, with minimal impact on graft survival rates. Overall, the findings provide both theoretical and practical guidance for the design of efficient, implementable allocation mechanisms."],"dc:description.abstractgeneral":["Every year, thousands of patients die while waiting for a life-saving organ transplant, even though many donated organs never get used. This research looks at how to make organ allocation fairer and more effective by introducing what are called targeted priority programs. These programs give certain groups of patients, such as older adults, earlier access to organs that are less likely to be used otherwise. In return, these patients give up priority for the highest-quality organs, making it easier to match every organ with the patient who can benefit most. The study shows how patients might respond to such programs, and how the rules can be designed to encourage participation without disadvantaging those who are not eligible. A detailed computer model of the U.S. kidney transplant system suggests that, with the right design, targeted priority programs could prevent more than 60 deaths each year, reduce the waiting list by over 450 patients, and add about 220 extra transplants annually—all while keeping transplant success rates nearly the same. Although no policy is perfect, this approach offers a promising way to make better use of donated organs and give more patients a second chance at life. By carefully choosing which patient groups to include and how to balance trade-offs, policymakers could create a system that is both more efficient and more equitable."],"dc:description.degree":["Doctor of Philosophy"],"dc:format.medium":["ETD"],"dc:identifier.other":["vt_gsexam:44663"],"dc:identifier.uri":["https://hdl.handle.net/10919/137649"],"dc:language.iso":["en"],"dc:publisher":["Virginia Tech"],"dc:rights":["In Copyright"],"dc:rights.uri":["http://rightsstatements.org/vocab/InC/1.0/"],"dc:subject":["targeted incentive mechanisms","social welfare","queueing games"],"dc:title":["Targeted Priority Mechanisms in Organ Transplantation"],"dc:type":["Dissertation"],"thesis:degree_discipline":["Industrial and Systems Engineering"],"thesis:degree_level":["doctoral"],"thesis:degree_name":["Doctor of Philosophy"],"thesis:institution_name":["Virginia Polytechnic Institute and State University"]},"updated_at":"2026-07-22T22:20:31Z"}