Network Design and Service Operations for Heart Transplant Under Preservation-Extending Technology

Despite efforts to increase the heart supply for transplantation, nearly 68.9% of donor hearts were unused. Current emphasis is placed on the information asymmetry between transplant candidates and the allocation system. Recently, a disruptive technology called the Organ Care System (OCS) has been shown to significantly extend heart preservation time. To improve heart utilization, this study develops an analytical and operational framework that jointly considers information asymmetry and OCS deployment. For patient self-selection of transplant centers with private information, we propose an incentive-compatible mechanism that encourages candidates to adhere to their declared willingness. For OCS deployment with a limited financial budget, we design a transplant network that maximizes patients’ social welfare. Theoretical analysis for small-scale transplant networks identifies equilibrium transplant menus, encompassing transplant rates and waiting times, for each transplant center. Specifically, we find that time-insensitive patients on the queue may be strategically delayed from receiving transplants when the sensitivity gap between patient types is small. This sensitivity gap is determined by the heart supply and the rate of time-insensitive patients. Case studies show that the OCS technology can improve social welfare and reduce organ wastage. Moreover, time-sensitive patients benefit more than time-insensitive patients. Empirical evidence confirms the existence of strategic delays, as verified in the theoretical analysis.

Funding: This work was supported by the National Natural Science Foundation of China (NSFC) [Grants 72401121 and 72571122].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/serv.2024.0187.