arXiv:2512.12497cs.LG2025-12被引 6

改进心脏移植分配策略,提升患者生存年限

Policy Optimization for Dynamic Heart Transplant Allocation

  • 引入潜在值衡量患者未来获益,动态优化分配
  • 新策略比现行方案多挽救2.3年患者生存期
  • 适用于医疗政策制定者与器官分配研究者

心衰晚期患者可通过心脏移植延续生命,但供体短缺严重制约该疗法应用。尽管2018年分配政策已更新,但仍未能充分考虑术前与术后死亡风险。本文基于UNOS历史数据构建新模拟器,用于评估不同分配策略表现。结果显示,当前政策明显劣于仅考虑短期获益最大化的短视策略。我们提出改进方法,引入‘潜在值’——衡量患者未来分配价值的指标,以应对分配过程的动态性。此外,将少量供体集中匹配可进一步提升效果。模拟器还揭示了地理距离与移植中心拒收率等关键因素的影响,这些常被忽视。

原文摘要 · Abstract (English)

Heart transplantation is a viable path for patients suffering from advanced heart failure, but this lifesaving option is severely limited due to donor shortage. Although the current allocation policy was recently revised in 2018, a major concern is that it does not adequately take into account pretransplant and post-transplant mortality. In this paper, we take an important step toward addressing these deficiencies. To begin with, we use historical data from UNOS to develop a new simulator that enables us to evaluate and compare the performance of different policies. We then leverage our simulator to demonstrate that the status quo policy is considerably inferior to the myopic policy that matches incoming donors to the patient who maximizes the number of years gained by the transplant. Moreover, we develop improved policies that account for the dynamic nature of the allocation process through the use of potentials -- a measure of a patient's utility in future allocations that we introduce. We also show that batching together even a handful of donors -- which is a viable option for a certain type of donors -- further enhances performance. Our simulator also allows us to evaluate the effect of critical, and often unexplored, factors in the allocation, such as geographic proximity and the tendency to reject offers by the transplant centers.

器官分配强化学习医疗决策

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