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Open 1-Megan Shivy Thesis.Pdf THE PENNSYLVANIA STATE UNIVERSITY SCHREYER HONORS COLLEGE DEPARTMENT OF SUPPLY CHAIN AND INFORMATION SYSTEMS THE OPTIMIZATION OF ORGAN TRANSPLANTATION MEGAN KAITLAN SHIVY SPRING 2015 A thesis submitted in partial fulfillment of the requirements for a baccalaureate degree in Supply Chain and Information Systems with honors in Supply Chain and Information Systems Reviewed and approved* by the following: Robert Novack Associate Professor of Supply Chain Management Thesis Supervisor John Spychalski Professor Emeritus of Supply Chain Management Honors Adviser * Signatures are on file in the Schreyer Honors College. i ABSTRACT The purpose of this thesis is to give a high level overview of the supply chain process associated with organ transplantation in the United Sates. Using information on organ transplantation programs from other areas of the world coupled with input from transplant expertise this thesis will highlight areas for logistical improvement to improve the success rate of organ transplantation in the United States. This thesis concluded that while the ultimate solution of improving the success rate of organ transplantation may take legislative action, standardization of transportation by organ is a viable option to save the lives of people waiting for life saving transplants. ii TABLE OF CONTENTS LIST OF FIGURES ..................................................................................................... iii LIST OF TABLES ....................................................................................................... iv ACKNOWLEDGEMENTS ......................................................................................... V Chapter 1 Introduction ................................................................................................. 1 Chapter 2 Organ Transplantation Overview in the United Sates ................................. 3 Approval for Organ Transplant Waiting List ................................................................... 3 Becoming a Donor ........................................................................................................... 4 Obtaining Consent ............................................................................................................ 4 Matching Donors with Recipient ..................................................................................... 5 Recovering and Transporting the Organ .......................................................................... 7 Transplanting the Organ ................................................................................................... 7 Chapter 3 Network Optimization Trends in the United States .................................... 9 Kidney Paired Donation ................................................................................................... 9 Organ Preservation ........................................................................................................... 10 Xenotransplantation ......................................................................................................... 11 Chapter 4 Organ Transplantation Optimization in Europe .......................................... 13 Organización Nacional de Transplantes (ONT) ............................................................... 13 Transplant Coordinators ................................................................................................... 14 Chapter 5 Standardized Transportation Network ........................................................ 16 Strengths ........................................................................................................................... 17 Weaknesses ...................................................................................................................... 19 Opportunities .................................................................................................................... 19 Threats .............................................................................................................................. 20 Chapter 6 Opt In Versus Opt Out Legislation ............................................................. 22 Chapter 7 Conclusion ................................................................................................... 24 BIBLIOGRAPHY ........................................................................................................ 26 iii LIST OF FIGURES Figure 1. Allocation Regions United States Map ................................................................... 6 Figure 2. Organ Donation Process ........................................................................................... 8 Figure 3. KPD Donor Chain (CPMC, 2015) ............................................................................ 10 iv LIST OF TABLES Table 1. SWOT Analysis Standardized Transportation Network ............................................ 17 v ACKNOWLEDGEMENTS I would first like to thank my thesis supervisor Dr. Novack for his guidance throughout my undergraduate academic career and continuous support in creating a thesis surrounding my passion, organ donation. I would also like to thank my parents for their unwavering support through the roller coaster we like to call life. Your love and guidance has shaped me into the person I am today and I could never put into words how thankful I am for you both. Most importantly I would like to thank my donor as well as the strength of their amazing loved ones for granting so many others and myself with a second chance at life. Every day I am reminded of the blessing I have received to live each day of this beautiful life with a new heart. 1 Chapter 1 Introduction Organ donation is the donation of either biological tissue or an organ from a human to either a living or deceased person to a living person who is in need of a transplant. According to Donate Life America, a nonprofit organization aimed at educating the public on organ donation, another name is added to the national organ transplant waiting list every ten minutes. The issue is the one person being added every ten minutes is being added to an already alarmingly long list of patients awaiting an organ donation. On the website for the United Network for Organ Sharing there is a live update of organ transplant statistics and on March 21, 2015, 116,888 patients were awaiting an organ donation. Eighteen people will die each day while waiting for an organ which amounts to about 7,000 deaths per year. With only 30,000 transplants performed in the United States each year in order to save the lives of those awaiting a transplantation there needs to be a drastic change to the network to increase the amount of transplants each year while also spreading awareness of donation. The basis of supply chain is balancing the variability associated with supply and demand. It is difficult to reduce this variability in terms of organs because there are simply not enough organ donors, the supply, in the United States to transplant patients awaiting organ donation, the demand. This organ shortage can be largely attributed to a law in the United States requiring citizens to opt-in as organ donors, opposed to opt-out as many European countries are, most notably Spain. Because of this, more than 90 percent of people are organ donors in Europe. It is reported that 67 percent of New York State’s residents strongly supported organ and tissue 2 donation, yet only 13 percent of the state's residents 18 and older were actually on the Donate Life Registry (USA Today Cara Matthews, 2010). The United States has adopted an extensive education campaign and easily expanded the pool of organ donors, however, the amount of donors is still not enough. This thesis will look into the current network that is in place for organ donation including an in depth overview of the extremely complex process of organ donation. By looking closely into each organization’s role and relationships there are clear areas for improvement; specifically highlighting a standardized transport network. It is difficult to quantify the effect such changes could have on the organ transplantation environment, however, small changes to increase the number of successful transplants, coupled with opt-out legislation, open up the opportunity to save the lives of many Americans. 3 Chapter 2 Organ Transplantation Overview in the United Sates Approval for Organ Transplant Waiting List The first step for transplant candidates is to obtain approval to be on the Organ Procurement Transplant Network (OPTN) national waiting list. In order for a patient to be eligible to be listed on the national organ transplant waiting list there is a series of screenings set- up by the transplant hospital ending with a final review by the board at the transplant hospital. Due to the amount of time a transplant candidate will wait based on the organ shortage this process is often done earlier than necessary to be sure the patient will be healthy enough for transplant when the time comes. At the transplant hospital the transplant candidate and their family undergo screenings regarding financial concern, emotional support systems, genetic testing, as well as a full health evaluation. Nurses, physicians, doctors, and the transplant coordinators then join together to discuss their findings from the screening sessions. If the transplant hospital feels the patient and family have the ability to have a successful transplant then they are listed on the OPTN national transplant waiting list. If the transplant
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