Table 1. Simulation outputs from LSAM; by allocation scenario.
Four allocation scenarios are compared: the current policy of local-first allocation, fully regional sharing using the current map, and fully regional sharing using the alternative maps designed by redistricting optimization (as shown in Figure 1). Standard errors are shown in parentheses. The last row quantifies geographic disparity as the variance of the median MELD at transplant among all DSAs.
| Local-First Current Map | Fully Regional Sharing | |||
|---|---|---|---|---|
| Current Map | Optimized Map 1 | Optimized Map 2 | ||
| Total deaths per year | 2727 (10.6) | 2680 (4.7) | 2651 (9.8) | 2650 (6.6) |
| Waitlist deaths per year | 1368 (3.3) | 1329 (2.2) | 1307 (5.2) | 1310 (4.4) |
| Median MELD at transplant | 25 | 25 | 26 | 26 |
| First offers for MELD<25 (%) | 14.6% | 4.6% | 3.3% | 3.1% |
| Transplants for MELD>25, Status 1 (%) | 51.9% | 57.2% | 60.8% | 61.2% |
| Pediatric transplants (%) | 6.6% | 6.9% | 7.0% | 7.1% |
| Transplants allocated locally (%) | 74.6% | 49.8% | 49.6% | 48.5% |
| Median transport distance (miles) | 68.5 (0.3) | 132 (0.6) | 143 (0.4) | 142(0.3) |
| Variance of median MELD at transplant | 11.2 | 13.5 | 7.0 | 8.5 |
Bold font signifies that the given metric is statistically significantly different from that for fully regional sharing with the current map. Only variance of median MELD at transplantation is statistically significantly different between Map 1 and Map 2 (see text). All comparisons between local-first current map and Map 1, and between local-first current map and Map 2, are statistically significant.