Math to Save Lives, From the Naval Academy

I am creating this blog mainly as a way of exploring my thoughts while getting active feedback from a diverse audience. As you read these posts, a great many things about me will be revealed as these are my thoughts, my interests, and a sort of inner monologue made public.Two of the greatest interest in life are Applied Mathematics and my loving wife. My wife, being the smartest woman I have ever known in my life, does not share my interest in mathematics being much more creative and artistically inclined than I. Recently, however, the two came colliding together.

First, I have to divulge some background information. Two years ago, at the age of 29, Mrs. Whizzer was diagnosed with ESRD (End Stage Renal Disease, more commonly referred to as Kidney Failure). Her family was tested to see if they could possibly be a donor, but because she was adopted their chances are no better than the normal population of being a match. Due to her blood type, here in Hawaii, the average wait time for a transplant is 7(+) years. Her doctor gives her 4 years, due to other complications. So we are moving to Connecticut. The waiting time in Connecticut is a little over three years, and trending down.

Now, let's talk about my other obsession - mathematics. A frequent problem within mathematics is optimization and/or minimization. Currently, 74,072 persons are listed nationally on the waiting list at the Organ Procurement and Transplantation Network (OPTN). Regionally (for Hawaii) there are 349 people listed, 89 of the same blood type as my wife. In 2007, for her bloodtype, there have been 3 deceased donors, 1 living donor (http://www.unos.org/).Advances in the field of kidney transplantation have made it possible to perform multiple transplantations at the same time. For example, let's say I decided to donate a kidney to my wife, but I can't because of mismatched bloodtypes. If a possible match could be made with another donor where I matched the patient and their donor matched Mrs. Whizzer, then we could do a swap and two patients would have a new kidney, a new life.Transplantation from a living donor has many advantages to transplantation from a deceased person. It is more cost efficient than dialysis over the long term, it is minimizes the time the patient is on the waiting list (thus minimizing the impact of kidney damage to other organs such as the heart and liver and shortening the list for persons with no donors), and the survival rate of the transplant is higher over the long term (http://www.livingdonorsonline.org/kidney/kidney2.htm).

Recent research involving graph theory have led to advances that could increase the number of kidney transplants, maximize compatibility of donor recipient pairs, and thus increase the long term survivability of the transplanted organ. The idea of using mathematical optimization to help these patients was discussed in a 2005 article in the Journal of the American Medical Association (http://jama.ama-assn.org/cgi/content/full/293/15/1883). Since the original publication of this article, it has been shown that this algorithm maximizes the number of transplants in every case, "it maximizes the total number of transplants while selecting matches with greater compatibility and closer proximity" (http://blog.sciencenews.org/mathtrek/2007/08/kidney_matchmaking.html).Yet, knowing this optimization exists, the logistical challenges are standing in the way of implementing this program to improve the lives of all persons awaiting kidney transplants. "To me, these results are not important until they're implemented," she [Gentry] says. "This theoretical work shows that these allocations can be done in a sane way, and if we're smart about it, we might get a large number of additional transplants in a year."Organ donation is an important lifesaving gift to those in need, those who are waiting with their life on hold. If you are able, please sign up to be an organ donor.

For more information on organ transplant and donation, in general, visit http://www.unos.org/.

For more information concerning paired kidney transplantation between incompatible pairs, visit http://www.paireddonationnetwork.org/ or for more information on the optimization of this type of donation, visit http://www.optimizedmatch.com/learn_index.php.

For more on the mathematics of this algorithm, visit http://www.cs.cmu.edu/~dabraham/papers/abs07.pdf

Also, if you are an organ donor, discuss your wishes with your family and the people who will make the decisions at the worst times. Their grief can, and often has unfortunately, canceled the donor card in someone's wallet. This discussion, as unpleasant as it can be could save someone's life.