The logistics of organ transplants – supply but inefficient distribution

An essay in the Wall Street Journal by David Weill titled ‘Supply Isn’t the problem with Organ Transplants” (December 6, 2019), describes the increased supply of organs in the US but an inefficient distribution of the organs to patients who need them, thus creating apparent shortages in the minds of patients and their families. He describes the organ procurement process, managed by network of 60 non-profit organ procurement organizations (OPOs), who operate under the department of Health and Human services oversight, and sets prices. He describes the increased deaths due to the opioid crisis, the eight different thoracic and abdominal organs that can be used from the cadaver, and the rush by various teams to get these organs and match it with their patients. But the matching of available organs to patients depends on the readiness to do the transplant, and delays in that stage may end up with a situation whereby 30% of lung transplant patients die because they never found a donor. What can be done to improve the logistics of supply and demand and thus provide better use of the donor organs ? Should OPOs be measured based on their success in placing organs ? Should doctor workloads be flexed to provide priority to use available organ transplants ? Can technology help improve the grim performance metrics for organ use in the US?

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55 Responses to The logistics of organ transplants – supply but inefficient distribution

  1. Chia-Yen Lu says:

    Systematically: The OPOs’ performance should be measured not merely based on the success in placing organs. It should also include other indexes such as the percentage of the patients who receive a suitable donation, and the average waiting time of the organs… etc. The current way of performance index would encourage hospitals/OPOs to conduct transplant surgery when they have the perfect organ. However, for an organ transplant, the patient is willing to accept the acceptable organ, instead of the perfect organ. Another point to point out is that doctors’ work priority should be adjusted, due to the timely cases of transplant surgery, the hospital needs to set the organ transparent duties ahead of other minor surgeries.
    The technology could also release the time pressure of the transplant timeline. As the Department of Health and Human Service is the higher department that auspices the 60 OPOs, it could invest several sets of the machine in some hospitals so that the machine could be used to lengthen the “live” of the organs.

  2. Amanda Tronchin says:

    It is essential to understand the “market” for organ transplants. Where is the demand by region of the United States and then by state. A similar analysis should be conducted on the supply side. It would identify which areas of the United States donate the most organs, then more specifically, which states. The OPOs should be strategically located within the United States to link the supply and demand.

    OPOs should not only be measured based on their success in placing organs. There needs to be a more holistic approach to evaluating OPOs. Another success factor could be the evaluating primary causes for the failures of placing organs. Analyzing the top 5 reasons and determining mitigation measures and approaches to reduce them. Once the current state is specified, then establish a target to reduce the number of occurrences.

    Flexing doctors’ workloads is a strategy that could be problematic to doctors, especially those who have regiment schedules. Doctors may not be accepting of flexed hours, therefore making it unfeasible. Yet, if this were not a concern, then this would be an excellent strategy to employ.

  3. Sruthi Madadi says:

    As the article suggests there is a clear lack of coordination among the members of the supply chain In this particular case of organ transplantation time plays a very critical role and the delays result in losing a life. Planning and on-time execution are required to satisfy the demand and fully utilize the supply.

    The non-profit organizations should invest in technology and develop an algorithm that looks for a better match of organs and sends an immediate trigger to the logistics team so that transportation could be arranged as early as they could.

    In addition to and transportation, doctor’s availability plays a key role. The schedule of the doctor should be flexible to prioritize the surgeries for the day. Doctors should always be in the loop in this flow of information and a real-time tracker has to be shared to provide the status of organs delivery. This will help doctors to make arrangements and adjust their schedules to perform the surgery.

    KPI’s should be introduced to track the performance of each of the OPOs. Each year Dept. of Health and Human Services should monitor the indicators and recognize the Top performed OPO’s And best practices should be shared. This would incentivize the 60 OPO’s to perform better.

  4. Yijia Chen says:

    First of all, OPOs in different regions should contact the local hospitals capable of organ transplant operations on both the demand and the supply sides. Secondly, all OPOs should build a public server platform in order to be able to share information to better face the uncertainty of transferring organs.
    The OPOs should not be measured only according to successful cases. They can consider starting from the perspective of different metrics, and classify the importance of different measurement standards into scores, and finally add up the scores of all metrics to judge expressiveness. These metric perspectives can be the reason for failure, the reason for logistics transfer, or the reason for success and efficiency.
    The doctor’s flexible working system should be adjusted for the priority organ transfer operations because the life span of the donated organ and the physical condition of the donor are not allowed outside the prescribed time. However, if OPOs and the hospital have better communication, the hospital can arrange the doctor’s operation schedule as soon as possible to avoid causing other patient delays or more serious consequences.

  5. Emma Wellington says:

    There are a couple things that can be done to improve the logistics of supply and demand of organs, specifically related to communication. Based on the process described in the article, hospitals aren’t always aware of every time an organ becomes donated. They are only aware of the ones deemed acceptable by the OPOs, which are most likely overly cautious due to the existing evaluation system. As a result, it is likely that some viable organs aren’t given a chance to be evaluated by transplant doctors. If a system were established that increased communication among doctors and notified of all available organs, then there is a potential for supply to be better understood. On the demand side, a database could be put together across the country of those in need and the specifications needed so that organs could be better matched. I believe this is an area where technology can also be utilized to keep the organs available longer prior to the transplant. This would allow more time to transport to the patient and for doctors to get ready for surgery. As a result, it is likely that technology could improve the number of transplants performed and hopefully the success of those transplants.
    In regards to measuring OPO success, I think that there should be a more established system for evaluating their performance. The system should be clearly communicated among the medical community and include metrics like success in placing organs and survival rate of patients. Additionally, I do think there is an opportunity to re-evaluate the schedules of doctors to see if there is a better system that can be implemented that allows for more flexibility. Since organ transplants are time sensitive, its important that the scheduling provides flexibility for those operations to occur.

  6. Sara Fortman says:

    At the moment, hospitals are not constantly being updated when organs are being donated, they are only alerted when there is a perfect match for one of their patients. Yes, it is best for the patient and organ to be a perfect match, but if they are almost a perfect match or even compatible, the hospitals should be notified and then there might not be as much of a waste of donated organs. There should be some type of system or database that tells the hospitals of the newly donated organs and then the next compatible patient should get the option whether to accept or deny the organ compared the current OPO way. This would also involve a more advanced technology system to be constantly updated and running. OPO’s should not be measured based on the successful pairing of organs and patients, it should be based on availability, distance, compatibility, etc. Distance is important because based on the current way of transporting organs if it is not within the same hospital, is to keep the organ in ice, but it has a limited amount of time it can be iced/exposed. This could also lead to a move advanced technology that can keep organs viable longer. If doctor workloads could be flexed to provide priority to use available organ transplants, that would be amazing. Doctors have to be present and in healthy condition to perform these surgeries, this also means they need to have flexible schedules to be able to prioritize different surgeries at a moment’s notice. Doctors also should be in constant communication regarding organ donations and their statuses. There are a lot of factors that come into play, but there are also many doctors who probably are not willing to have flexing hours.

  7. David Ng says:

    Life is precious, and it seems hospitals have coordination issues that prevent them from doing surgeries to the patients who need those organs. Even when the surgeons have suitable organs, they sometimes still refuse to do surgery for their patients if they deem the patients cannot survive more than one year due to the metrics they have. If we can change those metrics and perform surgeries on those patients who need those organs, then, perhaps, fewer people would pass away from this tragic event. Another issue that arises is that when there are available and suitable organs, surgeons may not be available time to go and acquire the organs to their patients. Perhaps, to solve this issue, hospitals can hire interns to acquire those organs for necessary patients. In this way, doctors can still perform surgeries to high priority patients while the interns can go acquire the organs for the patients. As far as technologies are concerned, I believe we should have a database that can notify to the hospitals where the nearest donors are and when they can acquire the organs for the patients.

  8. Dakota Ropp says:

    There is clearly a better way to organize the logistics better than they are now. That is because the amount of donations is not the problem. It is finding the correct placement for the donations they have that is the main issue. A way that I think could be considered to make the logistics better is to look at the patients that are waiting for the organs. What list is the longest and what are the specific requirements that are needed for the people on that list. This way we are not getting organs that are not necessarily needed right now, and will cause the organs to just go to waste. This would help to cut down on the amount of organ donations that will not be needed right now. It will also help with lead time. If people know what types of organs need to be donated, they might be more willing to donate these organs leading to a bigger supply for the organ needed the most. This could be done by creating a list of the top 5 most needed organs. People might be more willing to donate if they know exactly what they are donating. Now obviously it would not be like blood donations where they can hold on to it for a while. However, I still believe this method would work because there are more people learning about what needs donated, and they may be willing to help.

  9. Hao-Wen Weng says:

    The first part is to figure out what makes the logistics issues on organ donation and then we can start to optimize the match of supply and demand. For example, the network between the OPOs might not transparent enough or the information flow is not immediate causing the delay or failure on organ transplant. I assume that it will highly connect with the speed of delivery and how well the patient’s condition.
    I think it might not be precise to measure OPOs performance only based on their success in placing organs. It should also consider the quantity of organ donation they received and what kind of organs they received etc. The measurement should be more granular based on the category of the organ and average successful rate to know this OPOs performance and also provide a reference for the hospitals to cooperate.
    In my point of view, doctors workloads should be flexed to give priority to use available organ transplants. It is a matter to save one patient and at the same time, if it failed, there might be another patient who is eligible for this organ and lost the chance to be transplanted. I think the workloads of doctors should be the last priority to be considered since the organ transplant is much emergent.
    Technology definitely can improve the performance. For the logistics, the forecast of the traffic condition, the utilization of the transportation methods and how quickly we can send the organs to the destination are all the dimensions that we can enhance through the technology. Also the more accurate prediction on the match rate of patients and organs or making more convinced priority for the patients or organs will help improve the logistic system working smoothly.

  10. Lindsey Prommer says:

    From the supply side, transport time needs to be minimized. One way to increase coordination and reduce this transport time is to combine non-profit organ procurement organizations (OPOs). On the demand side, I recommend creating some sort of database for open communication between OPOs and hospitals with potential organ recipients. Technology utilized in this matter has the potential to greatly improve the performance metrics for organ use in the US. Additionally, OPOs should be measured based off of their success in placing organs and transportation time, which can help to align the priorities of all parties. Another option, though expensive in its own right, is to increase transplant team staff and doctors. I agree that flexible schedules for doctors will help transplant patients receive organs, should one be available. Given the imperative timeliness of transplants, doctors need to be able to maneuver their schedule to cater to these patients.

  11. Ting Lin says:

    Organ transplant recipients often describe the surgery day as the day they were “given another life.” Organ transplant surgery is a race about speed and luck. The roadblocks in the patient’s journey not only include the wait for available donors, but also the surgeons’ schedules and their incentives based on the success of surgeries. When patients are lucky enough to find a match, they might not be able to make it to the hospital due to availability and distance. Data transparency should be implemented with the organ procurement organizations. Real-time data will help surgeons understand the qualifications and match with their patients. According to the author of the article, we have no idea the adoption rate of quality organs by patients and where the organs were used. OPOs should measure their success based on their success in the efficiency and timeliness of organ procurement, organ categories, and the availability of surgeons to perform surgeries when there is a good match. A small team of surgeons should be delegated with the priority of securing organ supplies and informing all parties. They should also be given the flexibility in their schedules to meet the tight timeline of organ transplant surgeries. Technology can help with coordination, data visibility, and achieve timeliness of organ transplant surgeries.

  12. Shivang Batra says:

    A centralized system can be build that can be updated as soon as the donor organ is added to the inventory. All the healthcare systems must have an access to this system so that if there are requirements then hospitals can check into the system to search for the organ. In this way, supply will better meet the demand and results in a more seamless supply chain.

    In my view, an independent body comprising of doctors should be made which should make sure a pre-defined procedure should be followed as soon as an organ is donated and update the system with all the details like blood group and other key information. This system will help the healthcare sector to match the organ with the requirement without wasting time in organ search and helps in reducing lead time.

    There must be KPI’s measurement for OPOs performance that helps in finding the best performing OPOs based on their success in placing organs. They can share the practices they have executed to make their working seamless.

    Technology can help in real-time data sharing across end-to-end supply chain resulting in better decision making which would result in improving overall performance for organ use in the US.

  13. Zachary McClurg says:

    It would be vital to understand how the OPOs interact with the hospitals and doctors that conduct organ transplants and what type of tracking and allocation systems that are already in place. The federal government maintains a database called the Organ Procurement and Transplantation Network (OPTN). This database provides all the data available on candidates on the waiting list, organ donation and matching, and transplantations. This system aids in matching candidates with organs. Transporting organs to patients in waiting is a time sensitive matter and the logistics would also need to be understood. I believe it would be important to measure the OPOs on the ability to match organs in their respective area of operation and their ability to work together to place organs not needed in their region to others. From time of harvest, there is a window of only 24 to 36 hours before the organ needs to be transplanted. This removes the ability to set up regional storage facility for improved logistics. The best way to improve logistics would be to better the database and communications used and look into the hospitals and doctors capable of transplant. An investigation could be started on the willingness of volunteers with private planes and helicopters to aid in transportation and put those volunteers on a national alert system. Another investigation I would launch would be into regional flyaway teams for transplant for specialist that are in low supply. Doctors on staff at the hospitals should prioritize the time sensitive transplant patients, but we are already seeing staff shortages that may continue to increase with the pandemic and with some healthcare facilities laying off staff that are unvaccinated. I do believe technology can help with these poor performance metrics, but without the ability to transport and transplant in a timely manner, technology can only so useful.

  14. Yi-Hsuan Hsu says:

    The story of the young mother dying in the article is heartbreaking, and it also remind us to be more serious about the logistical issue. The cost of a wrong decision could be ultimately huge.
    To provide better use of the donor organs, first, the overall mechanism of transplanting organs should be changed. Nowadays, because the performance of the transplant-team surgeon is evaluated merely by the surgical results, surgeons become less willing to take the risks of doing the operations with higher risks. However, the operations involving higher risks are actually the more ”urgent” orders, and more “supply availability” should be provided accordingly. The current mechanism, however, encourage the surgeon to do the complete opposite ways. Secondly, the operations that the surgeon need to do should be adjusted and arranged according when there are available organs to be transplanted. From the logistical perspective, as the hospitals already know the fact that the “lead time” of matched organs are highly uncertain, and that it is much more difficult to acquire matched organs, compared to the other medical utilities and utensils, they should make the organ transplant as more prioritized tasks when they are making the doctors’ operation schedules. But to do so, the instant information exchange among the institutions that hold the donors’ organs, the transplant team, and the hospitals is needed. Lastly, technology is undoubtedly the key to improve the overall efficiency of the logistic system. Advanced technology could extend the time that the organs “alive” outside the body, and thus there would be more buffered time for the organs to be transported from one place to another. As for the problem of overseeing the machines and organs requires more personnel, I believe it is not unsolvable, because the hospital inject more resources to increase the capacity of overseeing the machines. For instance, they could train the other medical workers to learn how to oversee the machines, or they could recruit more people to join the transplant teams.

  15. Brian Mbui says:

    The matching process clearly needs an overhaul and more integration with technology whereby by the availability of an organ, it’s possible matches are identified via a system according to priority. This would work to reduce the wait time but it would not work at all if getting a doctor for the patient would be difficult. Therefore, hospitals need to invest in having a general surgeon who can perform most transplants on a human body available on call 24/7. If they can have two or more on a paycheck just to be available on demand for the sake of a transplant then that would be best. These may be dedicated doctors or just normal routine doctors who are made aware that they need to drop what they have on their schedules to attend to an urgent transplant. Doing so may call for a good duty allocation since the hospital needs to device ways of having a backup for this doctor that has been taken to the transplant so that they can keep their flow going with little to no interruptions. This might seem like an expensive option to the hospital but I believe at some point the value of human life needs to be placed above the balancing of costs involved.
    Measuring OPOs ratings based on their success is also something I’d recommend and it is because that would put pressure on the OPOs to make sure they are doing their best. If they fail to, that would mean poor ratings and no patient would look to a poorly rated OPO for services. The competition that would be sparked would serve to protect the patients at the end of the day.

  16. Su Tien Lee says:

    Time is needed for the readiness to do the transplants, therefore the OPOs should focus more on how to successfully transplant organs rather than rushing on getting the organs and do the matchings. First of all, I think OPOs should deal with the organs and the preparation of transplants at the same pace. Since the preparation is the most critical part, and the patients’ lives highly depend on this, OPOs should not rush only to finish the matching but to focus on the following steps as well.

    From the article we learned that the supply of organs is actually increasing, so the success rate in transplants should increase expectedly as well. If they can deal well with the coordination in both steps, the distribution of the organs to patients can be more efficient. For example, with the help of technology such as more freezers for organs and a cloud platform to see all the events in progress, the information between each stage would be more transparent and organs can be more nicely kept, shortening patients’ waiting time, lengthening the organs expiration time, thus improving the transplant efficiency and OPOs’ performance in organs.

    I think that OPOs are measured based on their success in placing organs can help improve their current bad efficiency since this method encourages them to think of a better way to solve their problem. We can give them successful rate KPIs, and gradually upgrade the KPI number to finally reach a more balanced supply and demand within this progress.

    Doctors’ workload can be more flexed, but not to an extreme pole that they deal with only the transplant operations. There should still be a balance between the most emergency and the most important operations because patients who don’t need a transplant may also need immediate operations.

  17. Wei Ling Huang says:

    To improve the logistics of supply and demand, waste of unused organs should be reduced as much as possible. However, the KPI of the OPOs is measured by success rate only, not utilization. That might make OPOs and doctors focus on perfect-match transplants and less willing to risk on just suitable organs, even if they are the only possibilities of keeping patients alive. Doctors should have flexible workloads so they can prioritize their surgeries based on emergency in terms of patients’ survival, but it is shortage of staff and overwork that make the situation difficult. Coordination within the hospital and among the hospitals are both important as the third lung offer in the case indicates. OPOs should create a transparent and consolidated system that provides critical information such as locations of patients in need and how many days they can wait for, potential suitable donors by distance that can be reached in time, so hospitals may be able to schedule the surgeries in a flexible range of time by priority as well as to stand by for taking the organs in time. Undoubtedly, technology of preserving the organs for longer period of time can give more buffer time for coordination, and thus help improve the logistics and performance for organ use in the US.

  18. Esha Kaushal says:

    The key to improving the logistics of organ transplants is “Effective Coordination”. Both OPOs and transplant centers play a role in placing organs successfully. There are things that OPOs can do better individually and things that transplant centers can do better individually but neither can increase transplants alone. There is a need for greater communication, transparency, and accountability between the parties involved.

    Technology can definitely play a major role in establishing communication between various parties involved. A database system that gets updated in real-time and reflects both the demands at the various hospitals in the state and the availability of an organ in OPOs can introduce transparency in the current system.

    Further, in addition to the transparency, both the OPOs and transplant centers should assume shared accountability and one part of that would be the availability of doctors and other staff to ensure successful transplants. Transplant centers could incentivize flexible schedules to encourage this practice.

  19. Calei Kelly says:

    This essay is a really highlights that the logistics of organ procurement could really be improved. Opportunities for organ transplants for often rare and very crucial in saving lives. I think measuring OPOs on how well they use the organs that are provided to them needs to be a part of the evaluation process. One-year survival rates are definitely an important metric, and thus both should be considered. Aligning OPOs goals with that of the patients better, would in turn improve the logistic priorities for these programs. Additionally, collecting data on how well organs available are used could help understand the problem better and work towards targeting problem scenarios. Reducing doctor workloads and adding more flexibility into their schedule is definitely something that can help solve this problem. By doing this, they would increase the total capacity of the system, and raise the opportunity that a life-saving transplant could be made in time. Technology also would assist in this process. Better tracking and forecasting could help better match supply to demand and could more quickly locate available teams. Technology isn’t the only key to making this system better, but better data analysis and logistics planning would help greatly.

  20. Vikram Narendra says:

    From the article, it is clear that there is a clear lack of coordination between the hospitals at the demand side and OPSs that facilitate the movement of organs. Although there is enough supply of organs, they aren’t available at the right time when the demand is needed. To overcome this, we could use technology that maps the doctor’s schedule and the expected time of arrivals for the organs. This will help the doctors prepare better for the organ transplant operation. To build accountability for the delivered organ, an outsourced agency(team up with retired doctors/surgeons) can evaluate the report sharing the reasons for any organ gone unused. Finally, the Department of Health and Human Services should be doing more in adding more surgeons in the system and re-distribute the availability of sureons toward the demand side

  21. Juan Bautista Rigal says:

    I believe there could be different things to do to improve the logistics in organ transplant situation. It is important to understand how time sensitive the process is and how to address current issues. It is mentioned that it isn’t a supply constraint process currently so things should be planned accordingly. If there is an increase in deaths due to opioids, then OPO should identify the areas where the consumption of opioids is established and well known. From there, they could build a database that could potentially predict where the organ donors may be available. This could decrease the lead time between from the extraction of the organ to the transplant operation. Moreover, OPO should also consider, not only their success but also do a root cause analysis for failures, this could launch actions to address these issues, and take OPO to another level where they can save more lives.
    On the other hand, doctor’s availability I believe it to be a far more difficult task. Doctors won’t accept being flexible for a potential transplant, they usually have tight schedules and there won’t be any benefits from it. Moreover, OPO could develop a team of their own and have contracts to be responsible for these transplants.

  22. Aadav Srimushnam Sundaranathan says:

    Slightly off topic, I could draw parallels to this issue with lack of availability of thumb impressions in police databases back in late 90s in India. Certain police jurisdictions collected thumb impressions even if there were accused in a trial, while certain prisons collecting only after they were successfully convicted. This lack of information shortage was seen as an issue of ability to nab the criminals and difference in performance of police authorities in different regions. The common issue that I see is postponement of information.

    As both are being in service of people with a sense of emergency, the parallel metrics to measure performance could be failure rate in performing a successful organ transplant despite a successfully available suitable donor, rather than a purely success metric. Because this metric, points towards the inefficiencies that needs to be fixed which can only be mitigated through transparent information flow amongst different databases and between various stakeholders (hospitals, doctors, OPO’s, volunteers, donors, recipients) and touchpoints in the process (doctor schedules, match data, timelines to harvest, store/transport, operate etc).

  23. bmyczkow says:

    In order to improve the logistics and efficiency of organ donation, a study could be conducted to asses the demand versus the supply across certain regions of the US. For example, if a region including the states of California, Oregon, and Washington has a monthly demand of 200 organs, and from said three states alone there is a supply of 300 organs. Then it would be most efficient source suitable pairs “locally” as this would significantly improve lead time. If however, a regions supply does not satisfy the demand, first all suitable matches should be conducted then sourcing from other regions could begin. Essentially the sourcing should be localized whenever possible to minimize lead time. OPOs should be measured on their ability to find matches with patients, and further measured on the speed with which they find suitable matches. Its paramount that the success of matches be used to quantify success because an improperly matched organ not only fails to help the person with whom they initially matched it with, but also someone who it could have helped but did not get it. Because organ transplants are time sensitive, Doctors should establish a practice that elective surgeries be lowered in priority when the possibility of transplanting an organ is confirmed. This would allow for maximum usage of resources and ultimately both patients would be treated.

  24. Nilo Cedeno says:

    I have heard from many people expressing their desire of donating and in their drivers licenses can subscribe this. In all the states, public institutions encourages users to become donors. So, there is not a supply problem, this is a inefficient distribution as the article mentions. I still consider that some of the medical doctors or services have in their mind other ideas but no vocation, and the problem starts there. A strategy to match demand and supply can be developed for specialists that currently live in this country. Also, specifications of organs or details of compatibility can be collected using data properly. I do not believe that is a scarcity of technical people or software. But I do believe that there scarcity of medical services or health professionals that give to this “market” special attention.
    In conclusion, to successfully overcome this issue, it is very important to develop a unique system or database information with clear metrics of the organs in supply and demand. After this, sharp logistics because in this “market” time matters. But there is not a successful process of supply chain if there is a shortage in the medical area, so if there are no doctors and/or no hospitals for surgeries, the entire system has failed.

  25. Nicholas Reverman says:

    Since distribution is the problem, the organ procurement organizations need to be held responsible for any delays, and any consequences of such delays. A solution here would be to decrease the number of OPOs in the network and have a more direct route to the Health and Human Services Oversight. A simple way to weed out the number of OPOs down to a select few, would be to grade these organizations by their effectiveness at placing organs, as mentioned already. Therefore, take the top 5-10 organizations, and have them expand and take over responsibility for different regions or areas of the country. This would allow much better coordination between fewer organ procurement organizations, instead of haphazard coordination between 60 OPOs that struggle to communicate their availability and matches for certain patients and the necessary organ(s). The network structure is ineffective here, due to the number of “separate” organizations, there is very little responsibility and too many different ideas going around the different organizations, where they take too long to respond or decide on the next plan of operation. Fewer people in charge, but with a more centralized, hierarchical structure would allow information to be collected more effectively at each level, and the top manager of each OPO could make a more expedited, effective decision on where and to who organs are needed in terms of priority. Having a more regionalized OPO structure, would also be effective in decreasing lead times to deliver organs if that is needed, as every minute counts with respect to this operation.

    A better work flex for doctors to perform these transplants could be beneficial. An idea would be to have a surgeon or two on staff in hospitals, and their primary duty is to perform transplants, and this way, expediting organs that match what is needed, can be far more effective. An idea to throw out there would be to have them assigned to a region as mentioned above, and they travel throughout the region wherever is necessary. Technology is going to be another key factor that will help cut out unnecessary delays in the supply chain of these, especially for these upper-level decision makers. Some sort of system where info is collected and input by lower tiers of the hierarchical structure, that the top manager in the OPO uses to ultimately decide on the logistics/supply chain of certain organs. Similar to an SAP type of system. Here performance metrics can be updated in current time, and top level managers can adjust their plan of action for the OPO that they are responsible for. With a system in place, these managers can understand the supply of organs they have, and the relative demand that is associated in their region, along with the necessary information on if they match. If needed, a manager could contact another region, to request an organ that matches a patient in their area, and have it delivered (assuming the contacted area has a surplus of said matched organ).

  26. Coumba Niang says:

    Due to the ethical nature of this topic, critical thinking is essential to be able to match the demand and the supply in a way where everyone has the same opportunity and access to an organ if needed. There are tons of supply available as people around the country are willing to donate their organs when available. One thing that I think can help would be to improve the database while improving the urgency factors and updating the database on an hourly basis. Let’s say someone urgently needs a kidney in the state of Kentucky; the database should be able to identify donors within the state and get started as soon as possible. If there are no available kidneys in the state, then they can be added in the database of neighboring states such as Tennesse, Ohio or Indiana. Obviously, in a perfect world this might not be possible as the patient might not have sufficient funds and priority can be given to another patient who doesn’t need a kidney urgently, but has the funds. I believe that finances should not be factored into the database as it create unfairness.

    Prices and whether or not someone is able to pay for an organ to be given services should be a metric used to assess OPOs success in placing organs; along with their response time and their matching capabilities. In terms of doctors workload, I do not think the problem lies on their schedule but rather making sure that there is a supply of doctor high enough that will be able to ease the overall flexibility. If not, then doctors should make decisions case by case by analyzing the severity of each one. Technology is in my opinion a powerful tool that can be used in the healthcare system in an effective way that should first profit the patient’s health above all other factors, most specifically in organ donations. I am excited to see the advancement of technology in the industry!

  27. Oladapo Olatunde says:

    We have to first understand that the OPO and hospital are at odds as the former is a non profit organization and financially constrained, while the latter is focusing on series of objectives. Some hospitals being more profit conscious than just organ donation. As people could die while waiting for organs, to improve the process, hospital workers could be properly educated on proper timeliness to make referrals to OPO. The relationship can be enhanced by aligning their interest. The OPO and hospital could discuss each other’s needs and constraints. They can work together to share information. OPOs should not be measured by success in placing organs as we do know this is a complex problem to solve. It will be of great help if doctors workloads could be flexed to provide priority to use available organ transplants. With such initiative, more lives can be be preserved. Technology can help improve the performance metrics if algorithm can be used to solve some of the complex problems for example used to match patients blood type and logistical factors such as distance and medical urgency to donors to recipients.

  28. Darsh Shah says:

    This is clearly a coordination issue and there is a dire need to use technology to make common communication platforms across all hospitals and non-profit organizations. One idea that can be implemented is to establish special organ transplant hospitals where doctors are specially trained for the job so that the transplant outcomes are high. The special hospitals should be developed based on the historical demand for organs in different states and regions across US. This strategy will help pool the risk associated with uneven distribution by OPO. With the use of technology, the matching process should be improved based on urgency and willingness for transplant.

    Overall, technological advancements is the key to reduce the risks associated with coordination among different entities.

  29. Li Ci Chuang says:

    To improve the logistics of organ transplant, we need to first analyze the supply and demand in this market, and some changes are needed. For example. the current measurement is not going well: the success in placing organs should not be the only factor when measuring OPOs, we need to consider failures as well. Or, more consideration should be put into the metric, because if we only care about the result: success or failure, more doctors may choose not to take such high risk to do the operation, causing more death.
    I agree that when adjusting doctor’s schedules into flexible one can efficiently help patients receive organs, but we should also consider the unwillingness from them and the challenge in communication. Since most doctors have tight schedules and their priorities for their own, or they just hold the specific belief, it may be difficult to convince to take any change. However, if we can do it, that will be a great strategy. And definitely, future advanced technology can help improve the overall logistics, for example, the technology to preserve organs for longer time or more perfect matching methods between donors and patients. Besides, I also think that building a centralized database to manage those organs details, patients, and donors can help organize the waiting, shipping, and operating a lot, They both help the organ use in the US.

  30. Jiandong Hu says:

    The shortage of organ transplant surgeons is the main issue that impacts the utilization of the donated organs. According to the report, organ transplant surgeons are always understaffed and fully scheduled with the other duties, so fewer available organs will be unused if more surgeons are trained for organ transplanting. Moreover, as the author mentioned, organ procurement organizations(OPOs) have limitations and flaws, such as coordinating different geographic OPOs, so there should be a data-sharing system between hospitals and OPOs. Data sharing encourages the connections and collaboration between hospitals and OPOs. If there is an available donor, the hospital could obtain urgent information from OPOs immediately. Therefore, it helps the hospital manage medical staff schedules. It would be infuriating that the donated organs are wasted because surgeons are not available. Last but not least, there should be more cutting-edge technology invented to preserve the organs longer so that the organs could be transported to further hospitals in different states.
    Success rate could be a measurement for OPOs, but I don’t think it will be the most important. The patient in the story lost the chance to get the donated organ just because of concerns about the success rate. If so, more donated organs would be discarded, and it will intensify the organ shortage. Hence, I think the available organ unused rate should also be considered in the measurement.

  31. Mu Hua Hsu says:

    In the supply chain, there is little coordination involved. I believe if they can have a more transparent information-sharing system between each part of the supply chain, the waste of organs could happen less. For example, organs suppliers could provide detailed information about the organs’ size, status, or donators’ facts before boarding in the sharing system. The possible receivers then could estimate their available surgeon, patients, and lead time, etc. to see whether it is a suitable organ or not the reduce the waste. Although the system might be costly to build, it could ultimately pay off in the long run.
    As for the OPOs, I don’t think using only the success in placing organs is a solid determining factor. Probably adding up more metrics, such as the types of organs, timeliness, or availability of surgeon, will be a better method as the definition of the success of placing an organ is way too complex.
    Although making the doctor workloads more flexible would be a way to provide priority to use available organ transplants, in reality, it is quite impractical. The medical system now is pretty insufficient. Patients have already difficulty getting treated by doctors, and it will be more complicated if trying to improve the flexibility of doctors’ workload.
    However, I think the technology approach might be a probable solution. Now, organs can live only 24 to 48 hours outside the body. If technology improves enough to make the organs last alive longer, the possibility of finding a suitable organ receiver during that time frame could be higher.

  32. Alexander Rabold says:

    The issues involved with successful transplants and the acquisition/transportation of organs are difficult to solve, largely due to the nature of the product in question. Organs don’t last for long once removed from the body, and depending on the availability of local donors, the window of time between when an organ is available for transplant and when it becomes too degraded to be effective can be very small.
    Effective communication between related parties and accurate estimates of demand are essential to ensuring people have access to organs when necessary. By providing quick updates on patients that need organs, the severity of their injuries, and already having a list of donors to view from, it could reduce the strain on the system. Technology could also help alleviate the strain, through methods like better predictive algorithms of demand, better methods of storing/transporting organs, and potentially even methods to keep patients alive for longer while waiting for full transplants, like artificial organs.

  33. Haoning Wang says:

    According to the development of the supply chain of organ transplants, I believe that the success rate must increase a lot. But it is deemed insufficient to a lot of patients (demand). Therefore, the main problem can still be the shortage of organs themselves. After reading the journal, in 2018 there were 35,529 organ transplants from 17,570 donors. But there are currently more than 113,000 patients on the waiting list for an organ transplant. It is a huge gap between donors and patients. Lack of sufficient organs is the main problem facing transplantation in the United States.
    In my personal perspective, the supply chain of organ transplants still needs to improve its efficiency in order to get a better logistics of supply and demand. There are always more people in need of organ transplants than people who have organs available. This is true all over the country, but not every place has the same number of available organs. Some areas have more registered donors, which means that the time you have to wait for the liver depends to some extent on where you happen to live. At this point, the countrywide supply chain should be founded and it is necessary to have organs delivered by some professional companies. I think doctors’ workloads should be fixed to provide priority to use available organ transplants since the organ is the most important to that patient who needs an organ to be alive. Technology can always help improve the grim performance. Thus artificial organs can be used for those patients as well in the future.

  34. Hasit Yarlagadda says:

    Organ transplant is a very time sensitive process. There is only a limited time for the patient to receive a matching organ. To improve the efficiency, OPSs should maintain a central database, where they are logging the entire supply of organs they have. They should register details like the age, blood group and additional organ details during the time of organ donation. Using this database, they should build an application to identify the best and closest match as per the entered patient’s details. US has enough supply of organs but lagging in proper distribution. This application will reduce the time for matching the organs and hence will improve the distribution.

    The OPOs success should be measured on the number of customers for whom they are able to provide a match, how fast they are able to match. They should also be given an incentive for achieving the fastest matching time or the highest delivery of organs. This would ensure that there is a healthy competition among the OPOs and push them to work harder to make the organ matching process more efficient.

    Doctors generally have a tight schedule and would not be ready to flex their hours. But if the doctors are constantly informed about the status of the organ’s availability, they might be able to adjust their schedule accordingly, since they know that organ transplants are time sensitive.

    Technology as mentioned in the above example could be used to improve the matching time. Also the latest developments in health technology could be used to increase the organ preservation time to allow greater time for organ delivery and availability.

  35. Zeyu Hu says:

    The small, scattered and overworked transplantation team is the bottleneck of entire logistics, improving capacity of bottleneck part is an effective way to optimize logistics. This is not simple. The transplant team is composed of highly experienced surgeons, who are scarce human resources, so it is impossible to expand the size of the team in a short time. However, we can improve the efficiency of existing transplant team by enhancing information visualization so that surgeons could learn where and when there are suitable organs in advance, making preparations earlier.
    Success in placing organs should not be the only criterion for OPOs to measure. The reality is that many doctors are unwilling to transplant a available but not perfectly matched organ in an emergency because of the measurement.

  36. harishgavva says:

    There is a clear lack of coordination among the members of the supply chain in this case. Time plays a very critical role when it comes to organ transplantation and the delays result in losing a life. Planning and on-time execution are required to satisfy the demand and fully utilize the supply.
    Investments in technology should be made to build a robust centralized database and a matching algorithm to match the donors with the patients need. In addition to this, doctor’s availability also plays a key role. The schedule of the doctor should be flexible to prioritize the surgeries for the day. A real-time tracker must be shared to provide the status of organs delivery. This will help doctors to plan and adjust their schedules accordingly to perform the surgery.
    A supply chain audit should be done to analyze the flaws in the flow of information between the OPO’s and there should be regulatory body to evaluate these organizations based on some key performance indicators. They should have annual meetings to share the best practices and continue to work on improving the lead times.

  37. Patrick Todjalla says:

    First, it is worth noting that this enterprise, the logistics of organ transplants (including procurement and distribution of organs to needing patients) is a non-for-profit business. So, making money for owners is not part of the equation. Success here would primarily lie on the number of viable organs collected and the numbers of patients saved in effect. The efficiency of the logistics although important, very important for that matter, is not to save much on costs, that is still a legitimate preposition. Like in any other business, waste must always be avoided. Though, in this case, efficiency, avoiding waste at any cost, means enough organs are collected and as much as possible patients are served and saved. Analyzing the situation of this discussion, it seems like the OPOs may be managing their inventories mostly in conjunction with affiliated patients, as such it looks like information are processed and managed in somewhat silos. A good alternative would be to pool inventories from suppliers (the network of 60 OPOs) on one side, and pool demand on another side (create a national pool of patients needing organ transplants). These two pools of data/information should be managed nationally, trying to match as many patients as possible to readily available organs in the entirety of the US, prioritizing patients with shortest time left to allow for a viable procedure. Basically, territory or belonging to a specific available organ market should not be top priority for selection to receive the organ. It makes much sense if that is the case for collecting organs from donors, where donors are directed to the closest OPO from their location to save on costs related to collection activities. Patients should be directed or sent to available organ market if that is a more viable way to dispense the organ rather than moving the organ across the country to meet customer demand. This then means that doctors workloads and schedules must be flexible enough to provide for such prioritization. A doctor would then be able to follow his or her patient to the location where the transplant organ is available, or a local doctor should be able to prioritize servicing a patient who was not his or hers to help deal with time constraint, in terms of patient survival time ratio. Finally, success for these OPOs should be measured by the number of patients receiving needed organs in time. OPOs are not charge for organs they collect from donors; however, their distribution of organs is paid for by charging recipients (hospitals, health insurance, and ultimately the patients). So, it is understandable if they are required to invest much in making the logistics of organ transplants as responsive as possible and always effective.

  38. Rubin Mao says:

    The percentage of placing organs successfully should not be the only matrix to measure the performance of OPOs. Sometimes the patient and the donated organ may not be placed successfully, but a huge amount of works have done prior to that stage. Their efforts and performance to collect information, find match, arrange tests or other jobs should not be ignored. For the next question, I believe that doctors should be flexed to provide priority to use available organ transplants. But is not easy for achieve. It will occupy a doctor’s time and effort to do the jobs, not only operate surgeries to patients, but also find match and available organs or arrange the logistics routes. Those work still need to be assisted by professions. Technology can improve the grim performance metrics for organ use and logistics of supply and demand. For example, a better matching system will help to record more information from both patients and organ donors, and help to find matches efficiently and effectively. A better and more case-focused cold chain logistics may help to store and transport organs quickly while not to influence the functionality of organs.

  39. Daniella Cobos says:

    I think that having an updated database that is checked on a daily or hourly basis by someone appointed is important. Due to the lack of information interchanged by the OPO’s and the hospitals leads to deaths. Another thing that could be implemented is having improved technology with a higher accuracy on the match between organ and patient. This will allow us to have a higher success rate in lowering the chance of the patient rejecting the organ.

  40. Colton Kaplan says:

    The OPOs should first do a root cause analysis on why they are failing to place organs. I believe a key reason is there is no visibility in the supply chain. Also, there is no standard operating procedure for the communication process. I definitely think that they should invest in updated technology to make data-driven decisions. They should have a system that has a constant flow of when and where organs become available for transplants. From there, the hospitals should get an alert and have flexible scheduling or on-call surgeons to prepare and execute the surgeries when needed. OPOs should be measured by the successful placement of organs along with optimized routes with the shortest time to the hospitals the surgery is taking place at.

  41. Wenbo You says:

    To improve the logistics of supply and demand and provide better use of the donor organs, the OPOs and the hospitals need to improve their coordination with each other. The supply of organ transplants is not able to be used to fulfill the demand very likely due to the information gap between the OPOs and the doctors. The OPOs need to be able to notify the hospitals once an organ is donated and ready for operation. The readiness of the donor organ is more likely to be first evaluated by OPOs instead of the doctors who conduct the surgeries and understand the patients’ condition better. This information gap may cause a suitable organ not to be given to the patient in need in time. And based on this reason, I think OPOs should be evaluated based on their success in placing organs to encourage quicker connection to the patients.
    If doctors are willing to adopt a flexible schedule, it would be beneficial to have their workloads flexed to provide priority to use available organ transplants. At last, setting up a digital system by OPOs to more quickly and directly release donor organ information to and collect patient information from hospitals will allow better coordination for two ends and improve grim performance metrics for organ use in the US.

  42. Vasif Yusifzada says:

    Inefficient distribution is a crucial problem, especially for transplant patients. As we can see from the article, the problem is caused by the inefficient logistics strategies followed by OPOs. As a result, their inaccurate expectation for the supply and demand of organs creates apparent shortages in the minds of patients. It should be the primary responsibility of OPOs to be in close contact with hospitals in order to understand the demand in this market. Also, OPOs can get help from the Health and Human services of each state, city, and county to understand the demand in each area. This strategy could be an effective way for OPOs to improve the logistics of supply & demand and implement an efficient distribution strategy.
    OPOs should not only be measured based on their success in placing the organs, there should be other factors also such as ‘how quickly they were able to match available organs with patients?’, their timing in satisfying the demands, etc. There could be also other performance measures that are used by Health and Human Services to evaluate the performance of each OPO and provide them with feedback at the end of every month. That could push the performance of OPOs and make them more competitive in the ‘market’.
    Flexing the workloads of doctors doesn’t seem to be an effective solution to this problem because not every one of them would want to accept it because of their tough schedules and as a result, it could lead to low performance in organ transplant operations. This strategy can only be effective if doctors voluntarily accept it.
    Finally, developing technologies can be an efficient solution to improve the performance metrics for organ use in the US. Especially, using technologies to lengthen the lifespan of donor organs can significantly decrease the death rates related to organ transplants.

  43. Sara Yung says:

    In order to improve the logistics of supply and demand and provide better use of organs, OPOs can consider enlisting a third-party logistics company or carrier to help transport and analyze the best lanes to send organs. I know from my internship in which human tissue had to be sent, carriers were required to have it sent and delivered through premium overnight services. I believe having these partnerships with a logistics company/carrier will be able to help OPOs appropriately share the need of organs. I think another aspect to consider is that sometimes the body does not accept a donor’s organ, so OPOs should not be measured based on their success in placing organs. I believe the OPO should be responsible in sharing what organs are available and figuring out what is the best route to get the organ to the patient. Doctors should be given the opportunity for these organ transplants, but they should not be the individuals in ensuring that the organ delivers (that should be the OPO’s duty). I believe technology can help improve the grim performance metrics for organ use. It would be able to tell OPOs on how the organ is being transported, organ conditions, faulty organ trails, and areas that need organs the most. Technology like this can be through a logistics company as well and can help OPOs provide more to those in need.

  44. Kristian Komlenic says:

    Obviously the first question to ask is, how do we deliver the organ to the right patient at the right time. This will take a huge amount of effort on OPO’s with sharing the data on transplant organs with hospitals. Having transparency between each other will help us deliver organ to patient and save him. If we have enough organs to save everyone, then why are we not. From logistical perspective it will take cooperation between OPO’s and hospitals where they should start requiring OPO’s to share the organs availability, status, and other features associated with it. Sharing information between each other will help us reduce the waste of organs and save more lives.
    Secondly is scheduling of doctors, how do I have enough doctors available to perform this task? Maybe we start hiring doctors where they work closely with OPO’s. If a lung patient needs a lung and OPO is ready to deliver, having a surgeon on hand within each of organizations where they can be called whenever, this could potentially help reduce the capacity of doctors.

  45. Chou Yen Hung(Misha) says:

    In order to improve the current logistics of supply and demand, the crucial key point is time. Delaying time will remain lots if unused organs. However, OPOs KPI make doctors focus on perfect-match transplants of the organ rather than finding suitable organs to prolong patient life. Therefore, the utilization rate of the organ will be pretty low. Hospital could provide coordination among patient and doctors to categorize and prioritize the urgency of the patient to find suitable organ in short time. This flexibility workload can help reduce the waste of unused organs. Furthermore, coordination between hospital also crucial in the logistics system. Take Taiwan as example, we have fully organ record system in government health insurance bureau. Once people donate organ will quickly record in system and categorize with different parts. All the hospital in Taiwan can see how much donated organs are left in the central system. OPOs should build a same consolidation system that provides logistics information such as organs location or inventory information to better understand supply and demand. I am totally agree that technologies helps preserving and delivering the organs to save more and more lifes.

  46. JASON B HARRIS says:

    The critical role timing plays in organ plant donation requires a federal regulation to implement a robust system streamlining the data and communication processes. Transport time needs to be minimized in order to increase the chances of transplant transmission. If transplant centers work together to strategically establish centralized locations across the country housing organs based on the region’s primary needs, the lead time can be decreased when sourcing these opportunities. Additionally, OPOs considerable success in organ placement can be leverage as transplant centers begin to develop a scalable model that can be fully implemented across the country. There are a number of components to consider when implementing a new model, such as budget constraints, the impact of cold ischemia time, and the non-binding time covering constraints. These factors provide further evidence of the need for the centralization of transplant centers. Doctors’ workloads should not be flexed, considering this would produce additional gaps and potential lead times in the organ transplant process. Additional doctors need to be hired to covers gaps if there is an increased need for doctors to flex their schedules. While technology can improve performance metrics of organ use, there is an additional need to increase labor, to ensure data is collected timely and appropriately while closing the gap in the streamlining process.

  47. Vinay Krishna Devulapalli says:

    Organ supply is more of a time-sensitive issue; patients will not have much wait time in emergency cases. The hospitals/physicians should have access to the availability of the organs and their characteristics. These organizations should invest in technology and use the effectiveness of historical data. One possible solution could be to have a portal on which the surgeons key in the answers to a questionnaire, and based on a set of rules; it would point out to the closest match available. They can make a sound judgment on the treatment process and prioritize the cases based on severity. Having a centralized database that collates information from all the NGOs would be in the best interest of everyone. Based on the transportation delays, the surgeons can plan the operation well in advance. OPOs success should be measured on how efficiently they were able to match the requirement to availability. These OPOs should have links with delivery services to deliver the organ in the stipulated time. Having a healthy competition and coordinating with one another by sharing the information would save many lives.

  48. Yilun Xie says:

    Organ transplant match can be difficult as it requires the receiver and the doner can have a match within a specific time frame. It is important for most of the OPOs to share a common centralized organ tracking system. The system should have the basic information and status of the organ within certain area. If any patient at any hospital within US boarder are looking for an organ transplant, they can go on the system and looking for the possible match. The system not only helps a better match, but also helps with the tracking of the organ transplant operations. OPOs should be measured based on the number of successful transplant operations. The metric should be based on the patient reaction, healing process tracking after the transplant surgery etc. Doctors need to play an important role in this system as they know more than anyone about the organ transplant surgery. They can help providing organ doner information and organ condition on the system. The system can give certification for experienced doctor, and they can give certification for different donating organs after they examined it, making sure that the organ is coming from an established background. And each successful organ transplant surgery record can be attached to each doctor, the doctor who give the certification or the doctor who did the surgery, as a job record, which can increase the credibility of the doctors.

  49. szargham says:

    I feel there is a lack of data availability from the both sides and the infrastructure for these type is not responsive enough. I feel all the hospitals most be in some sort of system and be aware to provide updates for both parties, either the patient or the organ donor. In addition, this data must be available to other NGOs or hospitals so the can connect a patient with the possible organ. In addition, there is a need for storage which I have no knowledge if the hospitals are already equipped with the necessary equipment or not. Overall, I think the problem is data transparency and availability. If they can find a way to have real-time data, the logistic part of it should be easier to manage.

  50. AKSHIT JAIN says:

    As per WSJ Article, even though with excess supply of organs from generous donors, timely delivery and success rate of placing an organ is low, resulting in uncertainty among patients and further enhancing demand for organs. As per my understanding, main reason for this mismatch in supply | demand, and lower success rate are lack of centralised controlling system (where organ donor and receiver data can be managed effectively), lack of coordination or information sharing among OPOs and hospitals management, lack of real time tracking of organ delivery and delay in organ transplant operations.

    From OPOs point of view, considering only successfully placing an organ order as the performance criteria for OPOs is unethical and unfair, for OPOs other performance criteria should be identify shortest possible lead time and proper information flow from OPOs to hospitals. Diving deeper OPOs management should list out major reason for low success rate of organ transplant and try to resolve those issues ASAP as delay in delivery or low success rate can result in higher death causality.

    From Technology point of view, OPOs and hospital management should work together to develop an centralised controlling system where records and data of all organ donors and receiver can be managed, this advance system will enhance transparency and provide holistic view of the whole situation. Apart from implementing centralised controlling system, massive improvement in real time tracking of organ delivery should be focus as tracking can help hospital management better judge the delivery date and allocation of hospital staff for organ transplant.

    In doctor’s daily schedule, top priority should be given to organ transplant operations and doctors schedule should be flexible enough to accommodate urgent organ transplant operations. Real time tracking of organ delivery can help hospital management for proper allocation of hospital staff and achieve higher success rate.

  51. Ahmed Hegazy Ali says:

    I think that a major problem in the healthcare system in America is related to information asymmetry. Information symmetry can reduce lead time and enhance scheduling time. From the article, we can understand that there is availability of organs, yet no correct person to collect these organs. Introduction of full information coordination software and notification systems within the healthcare system is essential (between healthcare providers and OPOs).

    I think many factors go into the placement of organs, and the majority are unrelated to OPO performance. For instance, a patient can reject an organ that appeared very compatible in terms of size and blood type. I think OPO performance should be slightly based on surgery success, but also majorly focused on lead time and speed in and out of an operating room.

    I don’t think the answer to physician workloads is simple. I think doctors’ schedules should be based on patient need. However, surges in doctor demand does occur, and this should be addressed through collaborations between physicians from different healthcare systems to assist each other. For instance, physicians can move between hospitals based on the supply of other physicians in other healthcare centers, and should not be limited to one hospital/region only.

    Information symmetry application such as EPIC and Athenahealth have been adopted in many hospitals, yet information asymmetry exists everyday. High adoption costs makes OPOs, providers, and insurance companies shy away from these softwares. Furthermore, uniformity and integrations between these systems should exist to any healthcare provider, with a lower price point; especially patient facing modules.

  52. Rajinder Budhiraja says:

    The ability to replace organs on demand could save or improve millions of lives each year globally. As the article clearly shares that the supply isn’t the problem, but matching it with demand is. And there are logistical coordination issues that make this challenging. In the US, Organ Procurement Organizations (OPO’s) are tasked with managing and coordinating an organ recovery process.

    To get straight to the questions being discussed, one recommendation to improve coordination between different entities of the organ transplant supply chain is to do a supply chain audit using the 4C framework to find potential areas to improve the performance of the entire supply chain, measured by the number of successful transplants. The logistics of supply and demand coordination is to leverage technology to make referrals less dependent on busy hospital staff. Hospital staff are extremely busy and have multiple concurrent responsibilities. While it would still be important for OPOs to coordinate with hospital staff once onsite, making the initial referral less dependent on staff will lessen the chances for human error and alleviate the burden on hospital staff

    The ultimate goal of OPO’s is to ensure a successful organ transplant, the higher the success rate the better its performance. The question if OPO’s success only be measured through successful transplants is not the best approach. There are other KPIs like average wait time waiting for a donor, percentage of people who receive successful matches, the number of organs procured, etc. should be included in measuring OPSs success criteria.

    Flexing doctor’s workloads may not be the ultimate solution to the problem. We must leverage technology in helping determine the workload priority of doctors to conduct other critical surgeries and transplants. Additionally, doctors may not be accepting of the idea of flexed hours, and their own performance of successful surgeries may be impacted by such changes.

  53. Anupam Choudhury says:

    t is mentioned in the article that separate organ teams arrive to extract the organ from the deceased, and whoever can get to the deceased faster obviously gets it. However, depending on the distance or other circumstances, other teams may not arrive on time, and thus, that organ goes waste. There were instances when the organ was available within the specified time window, but the doctors rejected the organ citing quality issues, and let the patient die rather than giving them a chance to live. These two issues highlight how departmental priority takes over rather than the intent to save lives. The first problem of teams not arriving on time can be easily solved by better coordination among different departments or better developing a new department specializing in organ retrieval. That way, two or more teams are not required to extract organs from the same cadaver, which saves not only time but also already strained resources. The second problem of organs getting rejected stems from the flawed performance tracking matrix employed by the OPOs, which incentivizes the rate of survival and not the rate at which organs are extracted and transplanted. Thus, for the sake of their reputation, organizations reject organs that might work, thus denying life to another individual.

    Furthermore, organ transplantation should be prioritized as an emergency procedure over all other procedures. It should be treated as urgently as an accident victim or a victim of heart attack is treated. The system must be so designed that an alarm is triggered as soon as an organ is reported available. Moreover, the nearest organ extractor team is despatched; this can be achieved by maintaining a joint database of teams with their location maintained, and the decision to send a team is purely done through efficient use of information technology.

  54. Abhishek Chippa says:

    Indeed, poor supply chain coordination is the main rootcause for unavailability of organs for patients in need. Amidst this poor coordination, it becomes highly important that hospitals give high priority to critical transplant surgeries when the organs are available and ensure the availability of doctors. Moreover, the current metric of successfully placing organs to evaluate the OPOs performance seems necessary but not sufficient. Regulatory agencies should also evaluate OPOs based on the number of quality organs that are turned down.
    In terms of technology, a common central database should be implemented to maintain the records of the donors. Software can be build on top it to automate and accelerate the organ matching process. This can save lot of time allowing transplant teams to plan their travel in advance to donor’s site.

  55. Chi-Wen Chen says:

    To this organ supply market, the key here is to create a platform that allows the people who need organ have the chance to be matched with the organs available. In this case, we can see that this organization does not provide a network with sufficient information for both parties and that’s why there is no demand & supply matching. One way is to centralize the information system that stores all of these info. Then, the next step is to rank the priorities from recipients according to their needs.

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