By Jonathan Sher, The London Free Press Wednesday, February 19, 2014 5:50:19 EST PM
They die waiting for transplants that might have come sooner if doctors heeded the advice of a London mathematician, whose published research could change the way patients wait for life-saving organs.
“Doctors are very intelligent people,’’ David Stanford of Western University said Tuesday. ‘‘They have a lot of grey matter. But they’re not given training to manage wait times at all.”
Now Stanford wants to change practice with research published this week in the journal Operations Research for Health Care with the help of an ally, a leading transplant surgeon who has served as president of the Canadian Society of Transplantation.
“I think it has a lot of potential,” said Dr. Vivian McAlister, who since 1990 has been one of four surgeons in London performing liver transplants as well as kidneys and the pancreas. “We want to make it as fair as possible.”
The queue for transplants is made more complicated by the fact that recipients have different blood types:
Type O blood are most common, about 46%, and their bodies accept organs from another type O.
Type A blood are common, about 42%, and accept from donors who are type A or type O.
About 9% are type B and accept from donors who are type B or O.
Just 3% are type AB and accept from donors who are type O, A or B, though the latter two are preferable.
Until recently, most countries, including Canada, too often use organs from type O donors on other blood types, leading to longer waits for those with type O.
“As a result, O patients wait much longer, more die, and those that remain have poorer transplant outcomes,” Stanford said.
Those waits led Germany to shut the door on transplanting organs from one blood type to another.
But that shift will cause excessive waits for those with the rarer blood types, Stanford said — type ABs will wait 15 times as long as a type O.
So Stanford devised formulas to even out wait times no matter the blood type of the recipient: 4% of type Os should be given to type Bs and 4% of type As to type ABs.
A computer would generate that ratio but in a random, systematic way, McAlister said.