A kidney paired-donation (KPD) program's aim is typically to maximize the number of transplants achieved via cycles among incompatible donor-candidate pairs, as well as chains originating from altruistic donors (AD). With many possible overlapping options in a KPD pool, a suitable choice of cycles and chains realistically cannot be found by simple inspection. In practice, objective criteria are used to determine near-optimal solutions. However, with the increasing complexity of the criteria used, solutions can be difficult to visualize. This research project aims to present software for the clinician that can aid in visualizing appropriate selections of exchanges to consider in KPD.

We present a software platform that implements a variety of optimization schemes described in previous literature, while offering the user an interactive and visual environment. The platform allows the user to filter subsets of pairs and ADs, compare multiple solutions under different optimization criteria, and examine the use of different match scoring assignments (eg. that account for other clinical aspects, such as waiting time). Our proposed platform offers the following advantages over other available software:

1. An interactive visual display of the current state of the KPD pool, including active and inactive pairs, as well as donor and candidate characteristics.

2. Implementation of several optimization options that can account for (a) probabilities of failure (between selection and transplantation) for each pair and match, and (b) fallback options in the selection of potential transplants to be evaluated.

3. Optimization extended beyond the selection of simple exchange cycles or chains, including optimal selection of subsets of pairs and ADs that facilitate fallback options in the case of failure.

Figure 1 shows a portion of a KPD pool. Red and blue circles represent pairs and ADs respectively, and arrows indicate potential transplants. The highlighted elements represent a potential solution that contains several chains and cycles.

CITATION INFORMATION: Bray M, Wang W, Rees M, Song P, Leichtman A, Ashby V, Kalbfleisch J. A Visualization Software Platform for Managing a Kidney Paired-Donation Program. Am J Transplant. 2016;16 (suppl 3).

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