Deciding kidney-offer admissibility dependent on patients’ lifetime failure rate

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We use developments in full-information optimal stopping to decide kidney-offer admissibility depending on the patient’s age in treatment, on his/her estimated lifetime probabilistic profile and his/her prospects on the waiting list. We allow for a broad family of lifetime distributions – the Gamma – thus enabling flexible modeling of patients survival under dialysis. We fully automate an appropriate recursive solution in a spreadsheet application. It yields the optimal critical times for acceptance of offers of different qualities, and the ensuing expected value-to-go as a function of time. The model may serve both the organizer of a donation program for planning purposes, and the particular surgeon in making the critical decision at the proper time. It may further serve the potential individual recipient, practicing present-day patient-choice. Numerical results and their discussion are included.