Optimal Liver Acceptance for Risk-Sensitive Patients

2018-09-01
Batun, Sakine
Bhandari, Atul
Roberts, Mark S.
The only therapy for patients with end-stage liver disease is transplantation. In order to be eligible for a cadaveric liver transplantation in the United States, a patient must join a waiting list maintained by the United Network for Organ Sharing System, which allocates livers using a complex priority system. When a liver offer is made, each patient must decide whether to accept the offer. Although several other models considered this decision-making process, they maximize life expectancy rather than expected utility, and hence do not apply to the vast majority of patients, who are risk-averse. We extend previous research by including patient risk preferences in our modeling approach. We formulate a risk-sensitive infinite-horizon Markov decision process in which the state is defined by the patient's health and the quality of the liver available for transplantation. Our model maximizes total expected utility for an exponential utility function, which provides good approximations for many other types of utility functions. We establish structural properties based on liver quality, health state, and patient's risk sensitivity, and we conduct numerical studies based on clinical data.
SERVICE SCIENCE

Suggestions

Structural effects of simvastatin on liver rate tissue: Fourier transform infrared and Raman microspectroscopic studies
Garip, Sebnem; Bayari, Sevgi Haman; Severcan, Mete; Abbas, Sherif; Lednev, Igor K.; Severcan, Feride (2016-02-01)
Simvastatin is one of the most frequently prescribed statins because of its efficacy in the treatment of hypercholesterolemia, reducing cardiovascular risk and related mortality. Determination of its side effects on different tissues is mandatory to improve safe use of this drug. In the present study, the effects of simvastatin on molecular composition and structure of healthy rat livers were investigated by Fourier transform infrared and Raman imaging. Simvastatin-treated groups received 50 mg/kg/day simva...
Upregulation of multi drug resistance genes in doxorubicin resistant human acute myelogeneous leukemia cells and reversal of the resistance
BARAN, YUSUF; Guer, Bala; Kaya, Pelin; Ural, Ali Ugur; Avcu, Ferit; Gündüz, Ufuk (2007-12-01)
The major problem in the treatment of acute myeloid leukemia (AML) patients results from multidrug resistance to administered anticancer agents. Drug resistance proteins, MDR1 and MRP1, which work as drug efflux pumps, can mediate the multidrug resistance of human leukemia cells. In this study, the mechanisms of resistance to doxorubicin-induced cell death in human HL60 AML cells were examined.
Alternative Polyadenylation patterns for novel gene discovery and classification in cancer
Beğik, Oğuzhan; Öyken, Merve; Can, Tolga; Erson Bensan, Ayşe Elif (2017-06-03)
Certain aspects of diagnosis, prognosis and treatment of cancer patients are still important challenges to be addressed. Therefore, we propose a pipeline to uncover patterns of alternative polyadenylation (APA), a hidden complexity in cancer transcriptomes, to further accelerate efforts to discover novel cancer genes and pathways. Here, we analyzed expression data for 1,045 cancer patients and found a significant shift in usage of poly(A) signals in cancers. Using machine-learning techniques, we further def...
Alternative Polyadenylation Patterns for Novel Gene Discovery and Classification in Cancer
BEGIK, Oguzhan; ÖYKEN, MERVE; ALICAN, Tuna Cinkilli; Can, Tolga; Erson Bensan, Ayşe Elif (2017-07-01)
Certain aspects of diagnosis, prognosis, and treatment of cancer patients are still important challenges to be addressed. Therefore, we propose a pipeline to uncover patterns of alternative polyadenylation (APA), a hidden complexity in cancer transcriptomes, to further accelerate efforts to discover novel cancer genes and pathways. Here, we analyzed expression data for 1045 cancer patients and found a significant shift in usage of poly(A) signals in common tumor types (breast, colon, lung, prostate, gastric...
Molecular investigation of therapeutical effects of Ɣ-tocotrienol conjugation therapy with doxorubicin on hepatocellular carcinoma cell line HePG2
Özyurt, İpek; Son, Çağdaş Devrim; Department of Biology (2017)
Hepatocellular carcinoma (HCC) is the fifth leading tumor of the liver tissue in terms of frequency of occurrence and third in terms of mortality. Even though, the most widely used chemotherapeutic agent doxorubicin in treatment of HCC had a great impact for development of therapeutic strategies preventing the progression of tumor formation and elucidating the physiological characteristics of tumor tissue. Moreover, use of doxorubicin minimizes the side effects of the drug in the individual and prevents the...
Citation Formats
S. Batun, A. Bhandari, and M. S. Roberts, “Optimal Liver Acceptance for Risk-Sensitive Patients,” SERVICE SCIENCE, pp. 320–333, 2018, Accessed: 00, 2020. [Online]. Available: https://hdl.handle.net/11511/38017.