A geographic information system and mathematical model based solution approach for optimization of Turkey's organ transplantation network

The first successful organ transplantation on human started with kidney transplantation in 1954. Nowadays, there has been observed significant improvements on organ transplantation all across the world. There are, however, numerous people who wait for organ transplantation. In Türkiye, the number people waiting for organ transplantation are continuously increasing as well. Organ transplantation process are managed by the Ministry of Health in Türkiye. There are nine Regional Coordination Centers (RCCs) under national organ transplantation center affiliated with the ministry. In Türkiye, 81 cities and centers where organ transplantation are performed in each city are operating affiliated with RCCs based on particular criteria. Time plays very crucial role for a successful organ transplantation due to geographical distance constraint between donor and recipient in delivering organ to recipient from donor and in implementing transplant operation. Inspired from Political Districting Problem (PDP), multi objective mixed integer programming formulation is developed with the objective of minimizing patient mobility and geographic dispersion in delivering hearth, kidney and liver to recipient from donor in our country. Developed mathematical model is solved by considering nine authorized RCCs in organ transplantation and affiliated cities. In the light of solutions obtained, RCCs which will service people who live in the cities under their authority are determined for hearth, kidney, and liver separately and city assignment consistency index together with current situation are comparatively examined. When kidney is investigated, City Assignment Consistency Index (CACI) for Adana is found to be the highest (88,89%) and CACI for Ankara is found to be the lowest (62,34%). When liver is investigated, CACI for Adana is found to be the highest (90,91%) and CACI for Ankara is found to be the lowest (62,99%). When hearth is investigated, CACI for İstanbul is found to be the highest (100%) and CACI for Antalya is found to be the lowest (50%). It is detected that 81 cities whose assignments were already performed by Ministry of Health under 9 RCCs must be assigned to different RCCs for organs kidney, liver, and hearth with respective ratios of 26.60%, 24.69% and 51.29%. Keywords: Organ transplantation, regional coordination center, mixed integer mathematical model, political districting problem, city assignment consistency index