A biologically based discrete-event simulation model of liver transplantation in the United States for pediatric and adult patients

We describe the framework of a discrete-event simulation of the national liver allocation system that incorporates the stochastic, disease-specific natural histories of pediatric and adult patients independent of allocation policies. This model will extend our previous work that only considered adult patients and organs. Our model will consist of patient and organ generators, a natural history progression module, and pre- and post-transplant survival estimation modules. While this is still a work in progress, our model will produce various statistics, such as the number of deaths while waiting for a liver, waitlist additions, the number of transplants performed, the number of wasted livers, and estimates of pre- and post-transplant survival at every time point for every patient.