HAS Online Seminar

Speaker: Sommer Gentry is a Professor of Surgery at the New York University Grossman School of Medicine, and Co-Director of the Center for Surgical and Transplant Applied Research. She is an operations research expert with decades of experience applying optimization and simulation to improve the transplantation system. She is a senior investigator with the Scientific Registry for Transplant Recipients. She designed matching optimization methods used for nationwide kidney paired donation registries in both the United States and Canada, and helped pass a law legalizing paired donation in the United States. Her redistricting work was also instrumental in pushing the Organ Procurement and Transplantation Network to make major policy changes that reduced geographic disparities in transplantation. Her work has attracted the attention of major media outlets including Time Magazine, Reader’s Digest, Science, the Discovery Channel, and National Public Radio. She was formerly a Professor of Mathematics at the US Naval Academy, and in that role received the MAA’s Henry L. Alder award for distinguished teaching by a beginning mathematics faculty member, was a finalist for the INFORMS Daniel H. Wagner prize for excellence in operations research practice, and received the US Naval Academy’s 2021 Civilian Faculty Excellence in Research award.

Seminar Title: Why do so many donated kidneys go untransplanted? A wicked problem and the discrete event simulations that might help.

Date and Time: Friday, March 27 at 1:00 PM (EST)

Abstract: Of 30,779 deceased-donor kidneys recovered for transplantation in 2023­­, 8583 (28%) were not used. The National Academies of Sciences, Engineering, and Medicine declared kidney non-utilization a critical problem that mandates immediate attention and remedy. Highly prioritized candidates receive many offers for kidneys that vary greatly in quality; these candidates usually refuse offers for non-ideal kidneys sequentially while the clock counts down to kidney non-use. Minutes matter because kidneys that have been recovered and stored degrade quickly while organ procurement organizations (OPOs) make offers for one patient at a time according to the allocation ordering. Many candidates would certainly have benefitted from receiving one of these non-ideal kidneys. I will describe as best I can why and how donated kidneys that could provide benefit go unused, and how I am applying discrete event simulation models to suggest alternative allocation rules that might help.

My argument is that reducing the number of donated kidneys that go untransplanted is a wicked problem. In fact, some and possibly most of the problems discussed at this IMSI conference should be reframed as wicked problems by enlarging the boundaries of the solution sets considered. Wicked problems are problems that I fear those with training like ours will reflexively formulate as optimization problems; wicked problems in fact are "ill-formulated, so neither the information to be obtained nor the solution set to be considered can be defined, and the ramifications in the whole system are thoroughly confusing." (Churchman/Rittel)